An 'admission challenge test' to predict severe hypertension in pregnancy?
Although many pregnant women are admitted to hospital for 'high blood pressure' during the third trimester, less than a third of them will subsequently develop severe hypertension. We used a Dinamap 1846 vital signs monitor to measure the blood pressure every 5 min during the first hour in hospital of a group of 51 previously normotensive pregnant women admitted with hypertension. An average systolic pressure at or above 140 mmHg was recorded in 37% of patients and, of these, 68% went on to develop severe hypertension. Conversely, if the average systolic pressure on admission was below 140 mmHg, only 3% of patients later developed severe hypertension. In terms of sensitivity, specificity, and positive and negative predictive values of severe hypertension, the 1-hour automated blood pressure profile was superior to conventional measurements whether they were made prior to admission, on admission, or during the first 24 hours after admission.
Mooney
P
P
Department of Obstetrics & Gynaecology, University of Cambridge, Rosie Maternity Hospital, U.K.
Dalton
K J
KJ
D000328:Adult; D001795:Blood Pressure Determination / Q000379:methods; D015924:Blood Pressure Monitors; D005260:Female; D006760:Hospitalization / Q000191:economics; D006801:Humans; D006973:Hypertension / Q000175:diagnosis*; D010343:Patient Admission; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis*