Гипертензивные нарушения беременности. Материнские и эмбриональные результаты лабораторных исследований, страница 14

: Кровяное давление Амбулатории, контролирующее в беременности.

AU: Walker-SP; Higgins-JR; Brennecke-SP

AD: Department of Perinatal Medicine, Royal Women's Hospital, Melbourne, Australia.

SO: Obstet-Gynecol-Surv. 1998 Oct; 53(10): 636-44

CP: UNITED-STATES

AB: Hypertensive disorders of pregnancy remain a major cause of maternal and perinatal morbidity and mortality. Diagnosis and management of these disorders has relied on conventional blood pressure measurement, a technique fraught with error and uncertainty. Ambulatory blood pressure measurement is a promising new technique that has the potential to overcome the inaccuracies of conventional blood pressure measurement. Several ambulatory blood pressure monitors have been validated in pregnant populations, and normal reference ranges have been established. More recent research has focused on the potential clinical roles of ambulatory blood pressure measurement in pregnancy. This review addresses the limitations of conventional blood pressure measurement and reviews the current literature on the application of ambulatory blood pressure measurement in pregnancy.

Гипертензивные нарушения беременности остаются основной причиной материнской и перинатальной заболеваемости и летальности. Диагноз и управление этих нарушений положились на обычное измерение кровяного давления, техника, чреватая ошибкой и неуверенностью. Измерение кровяного давления Амбулатории - многообещающая новая техника, которая имеет потенциал, чтобы преодолеть погрешности обычного измерения кровяного давления. Несколько приборов для наблюдения за кровяным давлением амбулатории были утверждены в беременных группах, и нормальные диапазоны ссылки(рекомендации) были отработаны(установлены). Более современное исследование сосредоточило на потенциальных клинических ролях измерения кровяного давления амбулатории в беременности. Этот обзор адресует ограничения обычного измерения кровяного давления и рассматривает текущую литературу по применению измерения кровяного давления амбулатории в беременности.

TI: Blood pressure excess for the early identification of gestational hypertension and preeclampsia.

: Избыток Кровяного давления для ранней идентификации гестациозной артериальной гипертензии и преэклампсии.

AU: Hermida-RC; Ayala-DE; Mojon-A; Fernandez-JR; Silva-I; Ucieda-R; Iglesias-M

AD: Bioengineering Laboratory, E.T.S.I. Telecomunicacion, University of Vigo, Campus Universitario, Spain. rhermida@tsc.uvigo.es

SO: Hypertension. 1998 Jan; 31(1): 83-9

CP: UNITED-STATES

AB: We have examined prospectively whether the combined approach of establishing tolerance intervals for the circadian variability of blood pressure (BP) as a function of gestational age, and then determining the so-called hyperbaric index (area of BP excess above the upper limit of the tolerance interval) by comparison of any patient's BP profile (obtained by ambulatory monitoring) with those intervals provides a high sensitivity test for the early detection of pregnant women who subsequently will develop gestational hypertension or preeclampsia. We analyzed 657 BP series from 92 women with uncomplicated pregnancies and 378 series from 60 women who developed gestational hypertension or preeclampsia. BP was sampled for about 48 hours once every 4 weeks after the first obstetric consultation. Circadian 90% tolerance limits were determined as a function of trimester of gestation from 497 series previously sampled from a reference group of 189 normotensive pregnant women. The hyperbaric index was then determined for each individual BP series in the validation sample. Sensitivity of this test for diagnosing gestational hypertension was 93% for women sampled during the first trimester of gestation and increased up to 99% in the third trimester. The positive and negative predictive values were above 96% in all trimesters. Despite the limitations of ambulatory monitoring, the approach presented here, now validated prospectively, represents a reproducible, noninvasive, and high sensitivity test for the very early identification of subsequent gestational hypertension and preeclampsia, on the average, 23 weeks before the clinical confirmation of the disease.