A prospective study of blood pressure in pregnancy: Prediction of preeclampsia (original) (raw)
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Journal of Babol University of Medical Sciences, 2020
BACKGROUND AND OBJECTIVE: Preeclampsia is a common disease during pregnancy that may be associated with maternal and fetal mortality. Since the pathogenic process of preeclampsia begins during the first trimester of pregnancy, it is very difficult to identify biomarkers of early detection of preeclampsia. The aim of this study was to determine the predictive validity of systolic, diastolic and mean arterial blood pressure in the first trimester of pregnancy in the diagnosis of preeclampsia. METHODS: This case-control study was performed on 200 pregnant women referred to Ayatollah Rouhani Hospital in Babol within a historical cohort. The data of the records of 100 pregnant women with preeclampsia diagnosis (case group) and 100 healthy women (control group) were filled in special forms and compared. FINDINGS: According to ROC curve analysis, in the first trimester for systolic blood pressure at the cut-off point of 117.5, sensitivity of 56% and specificity of 70%, for diastolic blood pressure at the cut-off point of 72.5, sensitivity of 68% and specificity of 63% and for mean arterial pressure at the cut-off point of 87.5, sensitivity of 67% and specificity of 66% were calculated. Based on the area under the ROC curve, the diagnostic power was 0.706, 0.663 and 0.709, respectively (p<0.001). CONCLUSION: The results of the present study indicate that arterial pressure can be used as an effective method in identifying women at risk for preeclampsia as a selection criterion in testing, treatment or prevention.
Ginekologia polska, 2011
The study was designed to determine the accuracy of using systolic (SBP) and diastolic blood pressure (DBP), mean arterial pressure (MAP), and increase of blood pressure (BP) to predict Preeclampsia (PE). We examined 300 normotensive and 100 PE pregnancies divided in two subgroups: mild (n = 67) and severe (n = 33) PE. The patients had a BP check in first and second trimester (SBFP DBP and MAP). We found out significant difference between the groups, but what is more important is that the difference in BP values (especially diastolic and MAP) existed before the pathological increase of the BP above the normal values. This was happening most often after 31 wg (at 92.5%) and less often after 26 wg (at 7.5%) at the pregnancies with mild PE while at the pregnancies with severe PE, 18,2% had increased tension after 21 wg; 24% in the period of 26-30 wg and 57.58% after 31 wg. Based on the results we could conclude that when BP is measured in the first or second trimester of pregnancy the ...
The study was designed to determine the accuracy of using systolic (SBP) and diastolic blood pressure (DBP), mean arterial pressure (MAP), and increase of blood pressure (BP) to predict Preeclampsia (PE). Materials and Methods: We examined 300 normotensive and 100 PE pregnancies divided in two subgroups: mild (n=67) and severe (n=33) PE. The patients had a BP check in first and second trimester (SBP, DBP, and MAP). Results: We found out significant difference between the groups, but what is more important is that the difference in BP values (especially diastolic and MAP) existed before the pathological increase of the BP above the normal values. This was happening most often after 31 wg (at 92.5%) and less often after 26 wg (at 7.5%) at the pregnancies with mild PE while at the pregnancies with severe PE, 18,2% had increased tension after 21 wg; 24% in the period of 26-30 wg and 57.58% after 31 wg. Conclusion: Based on the results we could conclude that when BP is measured in the first or second trimester of pregnancy, the MAP is a better predictor for PE than SBP and DBP.
A study of blood pressure levels and other factors that contribute to a good pregnancy outcome
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: The aim of this study was to investigate the awareness of blood pressure before and during pregnancy by pregnant women as well as the factors of pathological increase and if woman is going to adapt to the new situation changing their lifestyle and food habits during pregnancy .Methods: The study was conducted on 318 pregnant women to assess their knowledge and attitude about pregnancy and the development of high-risk pathology who had visited the Public Obstetric Hospital of Athens “Elena Venizelou”, from December 2019 to August 2020. Then were given a pre-designed structured questionnaire on socio-demographic, variable knowledge and attitude about health and pregnancy.Results: According to the study it was found that a proportion watching their diet (61%), limiting smoking (29% smoker, 12% of them smokes minimum), but a large number of them were unaware of preeclampsia (46%) and especially whether an increase in blood pressure occurs in preeclampsia (45%), leg...
Prediction of Preeclampsia by Mean Arterial Pressure at 11-13 and 20-24 Weeks' Gestation
Fetal Diagnosis and Therapy, 2014
Objectives: To assess the performance of screening for preeclampsia (PE) by mean arterial pressure (MAP) at 11-13 and at 20-24 weeks' gestation. Methods: MAP was measured at 11-13 and 20-24 weeks in 17,383 singleton pregnancies, including 70 with early PE, requiring delivery <34 weeks' gestation, 143 with preterm PE, delivering <37 weeks and 537 with total PE. MAP was expressed as multiple of the median (MoM) after adjustment for maternal characteristics and corrected for adverse pregnancy outcomes. The performance of screening for PE by maternal characteristics and MAP MoM at 11-13 weeks (MAP-1), MAP MoM at 20-24 weeks (MAP-2) and their combination was evaluated. Results: In screening by maternal characteristics and MAP-1, at a false-positive rate (FPR) of 10%, the detection rates (DR) of early PE, preterm PE and total PE were 74.3, 62.9 and 49.3%, respectively; the DR at FPR of 5% were 52.9, 42.7 and 35.8%. In screening by MAP-1 and MAP-2 the DR at FPR of 10%, were 8...
Mean Arterial Pressure at 11+0 to 13+6 Weeks in the Prediction of Preeclampsia
Hypertension, 2008
This study aimed to determine the performance of screening for preeclampsia (PE) by maternal medical history and mean arterial pressure (MAP) at 11 ϩ0 to 13 ϩ6 weeks. In 5590 women with singleton pregnancies attending for routine care at 11 ϩ0 to 13 ϩ6 week's gestation we recorded maternal variables and measured the MAP. We excluded 397 because they had missing outcome data or the pregnancies resulted in miscarriage or termination. In 104 patients there was subsequent development of PE, 97 developed gestational hypertension, 574 delivered small-for-gestational-age newborns, and 4418 were unaffected by PE, gestational hypertension, or small for gestational age. A multivariate Gaussian model was fitted to the distribution of log multiple of the median MAP in the PE and unaffected groups. Likelihood ratios for log multiple of the median MAP were computed and used together with maternal variables to produce patient-specific risks for each case. Detection rates and false-positive rates were calculated by taking the proportions with risks above a given risk threshold. In the unaffected group, log MAP was influenced by maternal age, ethnic origin, smoking, family and personal history of PE, and fetal crown-rump length. In the prediction of PE, significant contributions were provided by log multiple of the median MAP, ethnic origin, body mass index, and personal history of PE. The detection rate of PE by log multiple of the median MAP and maternal variables was 62.5% for a false-positive rate of 10%. Maternal variables, together with MAP, at 11 ϩ0 to 13 ϩ6 weeks identify a group at high risk for development of PE. (Hypertension. 2008;51:1027-1033.)
The Professional Medical Journal, 2021
Objective: To assess the diagnostic accuracy of mean arterial pressure in second trimester for prediction of pre-eclampsia in females. Study Design: Cross-sectional study. Setting: Department of Obstetrics & Gynecology Unit III, Allied hospital, Faisalabad. Period: October 2016 to September 2017. Material & Methods: Total 386 patients were enrolled after obtaining informed consent. Booked females of age 18-40 years, parity<5 presenting at gestational age >16 weeks (on LMP) for antenatal checkup were included in study. Patients with multiple gestation (on medical record and USG), Females with chronic hypertension (BP≥140/90mmHg), chronic or gestational diabetes (BSR>186mg/dl), Females having oligohydramnios (AFI<5cm) or polyhydramnios (AFI>21cm) on USG, females having abnormal placental implantation or placental abruption (on USG) were excluded. The mean age of the patients was 28.59±6.93 years. The MAP of the patients was 94.88±14.68 mmHg. Results: The sensitivity, sp...
Unique Blood Pressure Characteristics in Mother and Offspring After Early Onset Preeclampsia
Hypertension, 2012
Risk of hypertension in mother and offspring after preeclampsia is greater if preeclampsia develops early in pregnancy. We investigated whether those who develop early onset disease have unique adverse blood pressure characteristics. One hundred forty women were studied 6 to 13 years either after a pregnancy complicated by preeclampsia (45 women with early onset preeclampsia before 34 weeks gestation and 45 women with late-onset preeclampsia) or after a normotensive pregnancy (50 women). Forty-seven offspring from these pregnancies also participated. Data on maternal antenatal and postnatal blood pressures were extracted from maternity records and related to peripheral, central, and ambulatory blood pressure measurements in later life. Compared with late-onset preeclampsia, early onset preeclampsia was associated with higher diastolic blood pressure 6 weeks postnatally (86.25±13.46 versus 75.00±5.00 mm Hg, P <0.05), a greater increase in blood pressure relative to booking blood p...