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Abstract
Objective: To investigate if the 24-h ambulatory blood pressure (24-h ABP) monitoring technique could be useful in predicting the development of preeclampsia in women with chronic hypertension.
Design: A prospective study in which 24-h ABP was measured in each trimester and 12 weeks postpartum.
Method: Twelve women with untreated chronic hypertension had 24-h ABP monitoring performed with SpaceLabs 90207 monitor; eight normotensive women served as controls.
Results: In both the hypertensive and the control group there was a nocturnal reduction of the blood pressure. However, when the 24-h blood pressure profiles were analyzed separately for each woman, it was found that six women in the hypertensive group and six women in the control group at least at one measurement occasion during the pregnancy did not have any nocturnal blood pressure fall; one of the women in the hypertensive group developed preeclampsia. In the hypertensive group four women had no nocturnal blood pressure fall during the whole pregnancy, of these, one developed preeclampsia and one was subsequently in need of pharmacological treatment of the hypertension. When the 95% confidence limits for the hourly recordings of the hypertensive women with pregnancies without complications were calculated it was found that during the nighttime, two of the women who subsequently developed preeclampsia had a blood pressure level at the upper limit whereas the other woman who developed that condition had a blood pressure level at or below the lower confidence limit.
Conclusion: The 24-h ABP monitoring technique in hypertensive pregnancies seems to be of limited value in predicting the development of preeclampsia. The predictive value of an absent nocturnal blood pressure dip is limited as both normotensive and hypertensive women on several occasions during pregnancy showed such absence.