title: Blood pressure changes during the first stage of labor and for the prediction of early postpartum preeclampsia: a prospective study.
abstract: OBJECTIVE
  To assess systolic (SBP) and diastolic (DBP) blood pressure values during labor and to analyze their predictive value for early postpartum preeclampsia.
  
  
  METHODS
  This 6-month prospective observational study included 1435 women in labor who had no hypertensive disorders either before or during pregnancy. SBP and DBP were measured every 15 min during labor and signs of preeclampsia were checked for in the early postpartum period.
  
  
  RESULTS
  Mean maximum SBP and DBP were significantly higher during the first stage of labor without any treatment compared to the last prenatal visit: 135 vs. 119 mmHg and 81 vs. 74 mmHg, respectively (p < 0001). Epidural analgesia had no effect on maximum SBP or DBP during labor whereas oxytocin administration moderately increased SBP (137.8 vs. 135.2 mmHg; p < 0.05). Early postpartum preeclampsia was identified in 0.9% of the women. A maximum SBP equal or higher than 150 mmHg or DBP equal or higher than 91 mmHg during labor were predictive of early postpartum preeclampsia with a sensitivity of 77% and a specificity of 71%.
  
  
  CONCLUSIONS
  SBP and DBP values during labor are higher than those observed in the antepartum period. An SBP equal or higher than 150 mmHg or DBP equal or higher than 91 mmHg are associated with an increased risk of early postpartum preeclampsia.
authors.affiliation: CHI Creteil, CRC CHI Creteil, University Paris Est Creteil, Department of Obstetrics and Gynecology, Centre Hospitalier Intercommunal de Créteil, 40 avenue de Verdun, 94000 Créteil, France. Electronic address: drcohenjonathan@gmail.com.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Cohen
authors.affiliation: INSERM U1016, COCHIN, UMR8104 CNRS, 24 rue du faubourg St Jacques, 75014 Paris, France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Vaiman
authors.affiliation: The University of Texas Medical School at Houston, 6431 Fannin Street, MSB 3.286, Houston, TX 77030, USA.
authors.forename: Baha M
authors.initials: BM
authors.lastname: Sibai
authors.affiliation: CHI Creteil, CRC CHI Creteil, University Paris Est Creteil, Department of Obstetrics and Gynecology, Centre Hospitalier Intercommunal de Créteil, 40 avenue de Verdun, 94000 Créteil, France.
authors.forename: Bassam
authors.initials: B
authors.lastname: Haddad
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D005260:Female; D006801:Humans; D007747:Labor Stage, First; D007743:Labor, Obstetric; D049590:Postpartum Period; D011225:Pre-Eclampsia / Q000175:diagnosis* / Q000503:physiopathology; D011247:Pregnancy; D011446:Prospective Studies
keywords: Blood pressure; Labor; Postpartum preeclampsia; Prediction