Predicting the Development of Pregnancy-Associated Hypertension the Place of Standardised Blood-Pressure Measurement

Gallery, Eileen D.M.; Hunyor, Stephen N.; Ross, M.; Györy, Á. Z.

doi:10.1016/s0140-6736(77)91316-2

Cited by 64 publications

(27 citation statements)

References 4 publications

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“…Subclinical higher blood pressures (<140/90 mm Hg) in the first half of pregnancy are reported as a first sign of hypertension [1,19]. Our data are in line with this.…”

Section: Discussionsupporting

confidence: 91%

“…The heart is required to pump more blood to the brain and needs therefore a higher pressure. As mentioned above in the study of Gallery, cut off values depend on how the patients are positioned and thus it is important to interpret the observations relative to position specific thresholds too [1]. Applied on our study, based on AUC's, we noticed a slightly better predictive outcome with standing blood pressures instead of supine blood pressures.…”

Section: Discussionsupporting

confidence: 51%

“…Also Gallery et al identified lower 'at risk' blood pressure values at 17-20 weeks: the risks for hypertension were higher with blood pressure values above 110/75 mm Hg sitting or 100/65 mm Hg lying in left lateral position [1]. The latter group also observed that the fall in systolic and diastolic blood pressure from preconception to midgestation was larger in the normotensive than the hypertensive group, which is completely in line with the physiology or mentioned above [1].…”

Section: Discussionmentioning

confidence: 98%

“…During normal pregnancy, the blood pressure decreases in the first 20 weeks and then gradually returns to preconceptional values when term approaches [1,2]. Around 6-8% of all expectant mothers will experience an aberrant blood pressure pattern leading to diverse hypertensive disorders, with maternal and neonatal mortality and morbidity such as cardiac arrest, renal failure, premature delivery, low birth weight, intra-uterine growth restrictions etc.…”

Section: Introductionmentioning

confidence: 99%

“…Several studies [1,10,11] report already higher blood pressure values around 12 weeks of gestation in women who eventually develop preeclampsia, gestational or essential hypertension, compared to participate in a prospective, observational study. Approval of the Ethical Committee was obtained before study onset (MEC ZOL, reference: 13/090U).…”

Section: Introductionmentioning

confidence: 99%

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Optimization of Simple Sphygmomanometric Blood Pressure Measurement in Routine Prenatal Care

Vonck¹,

Oben²,

As³

et al. 2017

Health Care Current Reviews

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Background: Despite reported early subclinical hypertension of women at risk, blood pressures at threshold 140/90 mm Hg are used today to guide prenatal care. We aim to investigate the most appropriate gestation-specific threshold to measure early gestational blood pressures, allowing for a simple stratification between pregnant women at low/high risk for hypertension. Methods:Singleton pregnancies were selected at Clinic Oost-Limburg, Genk, Belgium. A standard protocol was used to measure systolic (SBP), diastolic (DBP) and mean arterial pressure (MAP) in supine and standing position, by mode of an oscillometric sphygmomanometer around 12 and 20 weeks of gestation. After delivery, outcome was categorized in normotensive or hypertensive pregnancies. In a subgroup, routine blood pressures retrieved from prenatal records were compared to standardized blood pressures. ROC analysis was used to define early gestational blood pressure thresholds with best discriminative performance for hypertension. All analyses were done in SPSS software (α ≤ 0.05).Results: A total of 780 women were measured at 12 weeks, of which 433 pregnant women were re-evaluated around 20 weeks. At both occasions, blood pressures were significantly higher in hypertensive than in normotensive pregnancies (p<0.0001). Analysis showed for DBP in standing position at cut off 79 mmHg a sensitivity, specificity, positive predictive value and negative predictive value of 72%, 64%, 15,5% and 96% at 12 weeks and 86%, 69%, 20% and 98% at 20 weeks at cut off 77 mm Hg. At 20 weeks, Area under the Curve (AUC) for DBP was 83% in standing position and 80% in supine position. For routine versus standardized blood pressure measurement, AUC was 66% versus 72% at 12 weeks and 69% versus 82% at 20 weeks, respectively. Conclusion:Simple blood pressure measurements with gestation-specific thresholds can easily be used worldwide towards improved planning of prenatal care as compared to current protocols. women who remain normotensive. Today, subclinical higher blood pressures (<140/90 mm Hg) are not considered clinically relevant. In this study, we evaluated whether early gestational diagnosis of subclinical hypertension would be helpful to identify the proportion of women destined to develop GHD, as early identification of those high risk cases could help decreasing the maternal and neonatal consequences [12]. Optimization of Simple Sphygmomanometric Blood Pressure Measurement in Routine Prenatal Methods PatientsWomen with singleton pregnancies in first or second trimester, attending the obstetric ultrasound clinic (Ziekenhuis Oost-Limburg, Genk, Belgium) for their routine obstetrics scans, were invited to

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“…Subclinical higher blood pressures (<140/90 mm Hg) in the first half of pregnancy are reported as a first sign of hypertension [1,19]. Our data are in line with this.…”

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 51%