A Randomized Controlled Trial of Complete Bed Rest versus Ambulation in the Management of Proteinuric Hypertension during Pregnancy

Evaluation of the mean arterial pressure to predict hypertension in pregnant adolescents

“…Based on the increased suspicion of pregnancy‐induced hypertension, the clinician could implement more frequent (ie, weekly) prenatal visits, encourage more frequent rest periods (ie, two or three half‐hour periods daily), instruct the client in relaxation techniques, and reassess the adolescent's dietary protein intake 18–20 . The efficacy of these measures to prevent PIH still is uncertain, 21,22 and their potential usefulness is based on early recognition of the gravida at increased risk 23 . The use of the MAP along with factors in the adolescent's social and family background permits the implementation of these additional measures.…”

Management of hypertension in pregnancy

“…Six trials enrolled 607 participants and compared ambulation out of hospital with bed rest in hospital 7 8 or ambulation with bed rest among women admitted to hospital with mild hypertension later in pregnancy. 9 10 No trials have enrolled women with moderate to severe hypertension. Figure 2 shows that there was no effect of restricted activity (with or without admission to hospital) on maternal or perinatal outcomes, although women managed as outpatients spent an average of 2.3 weeks (95% confidence interval 1.9 to 2.8) less in hospital.…”

Bed Rest in Pregnancy

“…A subset of 10 high‐risk patients was identified with hyperuricemia and severe fetal growth retardation. For this group, the authors found that bed rest led to fewer intrauterine deaths, but that women were more likely to experience premonitory signs of eclampsia 36. This study did not, however, comment further on the benefit of bed rest for the remaining patients who were not in this “high‐risk” group.…”