Enhanced prediction of pregnancy-induced hypertension by combining supine pressor test with mean arterial pressure of middle trimester.
Both the impact of the mean arterial pressure of the second trimester (MAP-2) on the development of pregnancy-induced hypertension (PIH) and the accuracy of the supine pressor test (SPT) for the prediction of PIH have been demonstrated. Despite good over-all predictability of the SPT, a large percentage of false positive SPT's have been reported, ranging from 6 to 60% with an average of 34%. In an effort to reduce the incidence of false positive SPT's and provide a more accurate method for identifying those primigravidas at risk for PIH, weekly or biweekly SPT's were performed. There were 251 SPT's performed on 97 primigravidas between 28 and 32 weeks' gestation. Along with the performance of serial SPT's, each subject's MAP-2 was calculated. Those primigravidas with an MAP-2 greater than 85 mm. Hg or two or more positive SPT's had a greater incidence of PIH (45 and 46%, respectively). Of greater significance, those women who exhibited both an MAP-2 greater than 85 mm. Hg and two or more positive SPT's had an 88% chance of developing PIH. These results were highly significant (chi square = 9.7, p less than 0.005).
D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000379:methods; D005189:False Positive Reactions; D005260:Female; D005865:Gestational Age; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000209:etiology; D011187:Posture; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis*; D011262:Pregnancy Trimester, Second