AUTOMATED BLOOD-PRESSURE MONITORING IN NORMAL-PREGNANCY

Objectives: The aims of this work were to establish automated blood pr essure monitoring (ABPM) standards during the three trimesters of preg nancy and to analyze the chronobiological trend of blood pressure duri ng gestation. Methods: A longitudinal study using 24-h ABPM was perfor med on 192 healthy pregnant women, (aged 20-42 years, mean+/-S.D. 28+/ -5) both nulliparas (n=85) and multiparas (n=107), and also on 26 preg nant women with chronic hypertension and 132 preeclamptic patients. Th e arterial pressure (AP) of the healthy women, at the start of the pre gnancy, was <140/90 mmHg, as measured by the standard mercury sphygmom anometer, and it remained so at subsequent check-ups throughout the pr egnancy and puerperium. AP was monitored using the Spacelabs 90207 (Ni ppon Collin, Takeda UA 751), beginning at 08:00 h. Results: The normal pregnancies demonstrated an AP circadian rhythm with daytime systolic (SAP) and diastolic (DAP) values about 8-9 mmHg (P <0.01) higher than at night. In the normal pregnancies, the mean 24-h AP values, like me an daytime and night-time, SAP and DAP values, remained the same in th e first two trimesters, while a slight but significant increase occurr ed in the third (P <0.05). Conclusions. This study enabled a range of normal pressure values to be deduced for each hour of the day througho ut the three trimesters of pregnancy. This may facilitate a more accur ate evaluation of individual pressure readings in pregnant women so as to ensure a more reliable and timely diagnosis of hypertension.