THE DURATION OF HYPERTENSION IN THE PUERPERIUM OF PREECLAMPTIC WOMEN - RELATIONSHIP WITH RENAL IMPAIRMENT AND WEEK OF DELIVERY

OBJECTIVE: The purpose of the study was to determine whether the durat ion of hypertension in the puerperium of preeclamptic women was relate d to certain clinical features or disease severity. STUDY DESIGN: We s tudied 269 singleton pregnancies divided into two groups: 159 with ges tational hypertension and 110 with preeclampsia. The normalization tim e of blood pressure in puerperium was estimated as the interval betwee n the delivery day and the first day when each of two to four self-mea surements per day of diastolic blood pressure was observed to be less than or equal to 80 mm Hg for at least 3 consecutive days. RESULTS: No rmalization time was shorter in gestational hypertension than in preec lampsia (6 +/- 5.5 [means +/- SD] vs 16 +/- 9.5, respectively, p < 0.0 001). Normalization time of gestational hypertension showed a signific ant correlation with uric acid (r = 0.20, p < 0.025); normalization ti me of preeclampsia displayed significant correlations with the week of delivery (r = -0.34, p < 0.005), uric acid (r = 0.34, p < 0.025), and urea nitrogen (r = 0.29, p < 0.025), respectively. After stratificati on by parity, in both groups the correlations of normalization time wi th renal data were observed only among multiparous women, whereas in p reeclampsia the link of normalization time with the week of delivery r emained highly significant in both subgroups. CONCLUSIONS: The differe nces observed between gestational hypertension and preeclampsia sugges t that distinct mechanisms or a different maternal answer to the same mechanism(s), in maintaining high blood pressure in puerperium, are pr esent in the two groups. Normalization time might reflect the recovery time of the endothelial damage in preeclampsia.