The Value of the Mean Arterial Blood Pressure in the Second Trimester (MAP-2 Value) as a Predictor of Pregnancy-Induced Hypertension and Preeclampsia. A Preliminary Report

Oney, T; Kaulhausen, H.

doi:10.3109/10641958309006081

Cited by 22 publications

(12 citation statements)

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“…Specificity, however, was as low as 7% for DBP in the first trimester. Sensitivity and specificity based on clinic BP values exceeding 140 or 90 mmHg for SBP and DBP, respectively are shown in TABLE 2. Results indicate a very poor sensitivity at all stages of gestation, mainly for DBP, comparable to that reported previously from other studies based on conventional office BP measurements [12][13][14][15][16][17][18][19]. As an illustrative example, the frequency histograms with the distributions of clinic BP and the 24 h mean of SBP calculated from the 958 4BP series sampled by 48 h ABPM in the second trimester of pregnancy are illustrated in FIGURE 5. The histograms in FIGURE 5A indicate the high degree of overlap between normotensive and hypertensive pregnancies in the distribution of the average of three to six clinic SBP values obtained at the time of each obstetric visit, just before the start of ABPM.…”

Section: Diagnosis Of Gestational Hypertension Using 24 H Mean Bpsupporting

confidence: 74%

“…Since an elevated BP after 20 weeks of gestation in a previously normotensive woman is common to the definition of both gestational For reprint orders, please contact reprints@future-drugs.com hypertension and pre-eclampsia [9][10][11], the issue of whether the development of these complications may be predicted on the basis of BP measured during conventional antenatal visits has been addressed in several retrospective and some prospective studies [12][13][14][15][16][17][18][19][20]. Office BP values, however, have several shortcomings; they provide a measurement that represents only a fraction of the 24 h BP profile, usually under circumstances that may have a pressor effect, and the technique is fraught with potential errors [21,22].…”

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confidence: 99%

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Prognostic value of ambulatory blood pressure measurements for the diagnosis of hypertension in pregnancy

Hermida¹,

Ayala

2004

Expert Review of Cardiovascular Therapy

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Several studies have indicated that the use of the 24 h mean blood pressure, mainly using reference thresholds derived from general nonpregnancy practice, does not provide an effective test for an individualized early diagnosis of hypertension in pregnancy, thus concluding that ambulatory blood pressure monitoring is not a valid approach in pregnancy. With the use of ambulatory blood pressure monitoring, epidemiologic studies have reported gender differences in the circadian variability of blood pressure and heart rate. Typically, men exhibit a lower heart rate and higher blood pressure than women, the differences being larger for systolic than for diastolic blood pressure. Moreover, normotensive and hypertensive pregnant women are characterized by differing but predictable patterns of blood pressure variability throughout gestation. However, the diminished blood pressure in nongravid women as compared with men, the added decrease in blood pressure during the second trimester of gestation in normotensive but not in hypertensive pregnant women and the large amplitude of the circadian pattern that characterizes the blood pressure of healthy pregnant women at all gestational ages, have not been taken into account when establishing reference thresholds for the diagnosis of hypertension in pregnancy. This review will describe these issues, summarize previous results from independent groups on the prognostic value of ambulatory blood pressure monitoring in pregnancy, propose answers as to an accurate reference threshold for blood pressure at different stages of gestation and suggest how this information should be used in order to identify those women at a higher risk of hypertension, who will also be more suitable for prophylactic and/or therapeutic intervention in the early stages of pregnancy.

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Section: Diagnosis Of Gestational Hypertension Using 24 H Mean Bpsupporting

confidence: 74%

mentioning

confidence: 99%

Prognostic value of ambulatory blood pressure measurements for the diagnosis of hypertension in pregnancy

Hermida¹,

Ayala

2004

Expert Review of Cardiovascular Therapy

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“…The studies reported widely contradictory results in the performance of screening, with DR of 8-93% [18,21] and FPRs of 2-55% [27,29], as a consequence of the varied methods in selection of the screened population, measurement of BP, cut-offs used in defining the screen-positive group and definitions of PE. The sample size ranged from 80 to 2,582 [16,29], the incidence of PE was 3-53% [15,31] and MAP was measured by either mercury sphygmomanometers or different types of automated devices at a wide range of gestations between 5 and 40 weeks [23,32].…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have examined the use of MAP in the first and second trimesters as a screening test for subsequent development of hypertensive disorders in pregnancy and the findings of all such studies are summarized in table 8[14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34]. The studies reported widely contradictory results in the performance of screening, with DR of 8-93% [18,21] and FPRs of 2-55% [27,29], as a consequence of the varied methods in selection of the screened population, measurement of BP, cut-offs used in defining the screen-positive group and definitions of PE.…”

Section: Discussionmentioning

confidence: 99%

Prediction of Preeclampsia by Mean Arterial Pressure at 11-13 and 20-24 Weeks' Gestation

et al. 2014

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Objectives: To assess the performance of screening for preeclampsia (PE) by mean arterial pressure (MAP) at 11-13 and at 20-24 weeks' gestation. Methods: MAP was measured at 11-13 and 20-24 weeks in 17,383 singleton pregnancies, including 70 with early PE, requiring delivery <34 weeks' gestation, 143 with preterm PE, delivering <37 weeks and 537 with total PE. MAP was expressed as multiple of the median (MoM) after adjustment for maternal characteristics and corrected for adverse pregnancy outcomes. The performance of screening for PE by maternal characteristics and MAP MoM at 11-13 weeks (MAP-1), MAP MoM at 20-24 weeks (MAP-2) and their combination was evaluated. Results: In screening by maternal characteristics and MAP-1, at a false-positive rate (FPR) of 10%, the detection rates (DR) of early PE, preterm PE and total PE were 74.3, 62.9 and 49.3%, respectively; the DR at FPR of 5% were 52.9, 42.7 and 35.8%. In screening by MAP-1 and MAP-2 the DR at FPR of 10%, were 84.3, 65.7 and 52.5%; the DR at FPR of 5% were 60.0, 49.7 and 37.6%, respectively. Conclusions: Performance of screening for PE by MAP is best when measurements are taken at both 11-13 and 20-24 weeks' gestation than at only one of these gestational ranges.

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“…Pemeriksaan MAP pada kehamilan 18-26 minggu, ROT diperiksa pada kehamilan 28-32 minggu. Dengan cara ini, preeklampsia bisa terdeksi secara dini (1,4 95,67 ± 34,39 p = 0,572 p = 0,347 p = 1,00 p = 0,085 Keterangan: Data disajikan dalam Mean ± SD, Uji beda dilakukan dengan uji t 2 sampel bebas. p = <0,05 signifikan.…”

Section: Pendahuluanunclassified

Perbedaan Efektifitas Pemberian Vitamin E 100 Iu Dengan Aspirin 81 Mg Untuk Pencegahan Preeklamsia Pada Primigravida

Baktiyani¹,

Wahjud

2013

JKB

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Preeclampsia is a specific disturbance of human pregnancy, that diagnosed by the onset of hypertension and proteinuria in the third trimester. It occurs more in developing countries, due to the fact that developed countries have better prenatal care. The objective of this study was to assess the difference effectiveness of preventing preeclampsia and giving vitamin E 100 iu and aspirin 81 mg. This study used prospective with single randomaised clinical trial. The place of this study is on Maternity care unit of RSUD Dr. Saiful Anwar Malang from October 2000 to October 2001. Fourty samples primigravidas between the age of 19-35 years were used in this study. Twenty four samples were treated with vitamin E and 24 samples were treated with aspirin started at the eighteenth weeks of pregnancy until delivery. The changes, of blood presure, albuminuri and oedema were observed. The result showed that during the observation the incidence rate of mild preeclampsia of vitamin E was 4 samples or (16,7%), mild preeclampsia was 1 sample or (14,2%) by the time of the normal delivery. On the other hand, the mild preeclampsia of the control group of aspirin was 3 samples or (12,5%) and mild preeklampsia was 2 samples or (8,3%) at the normal delivery. There is no significant difference in preeclampsia occurance between vitamin E and aspirin group.

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The Value of the Mean Arterial Blood Pressure in the Second Trimester (MAP-2 Value) as a Predictor of Pregnancy-Induced Hypertension and Preeclampsia. A Preliminary Report

Cited by 22 publications

References 5 publications

Prognostic value of ambulatory blood pressure measurements for the diagnosis of hypertension in pregnancy

Prognostic value of ambulatory blood pressure measurements for the diagnosis of hypertension in pregnancy

Prediction of Preeclampsia by Mean Arterial Pressure at 11-13 and 20-24 Weeks' Gestation

Perbedaan Efektifitas Pemberian Vitamin E 100 Iu Dengan Aspirin 81 Mg Untuk Pencegahan Preeklamsia Pada Primigravida

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