Halligan A, O'Brien E, O'Malley K, Mee F, Atkins N, Conroy R, Walshe J J, Darling M
Rotunda Hospital, Beaumont Hospital, Dublin, Ireland.
J Hypertens. 1993 Aug;11(8):869-73. doi: 10.1097/00004872-199308000-00014.
To establish the profiles of 24-h non-invasive ambulatory blood pressure measurement (ABPM) during the trimesters of pregnancy and the puerperium in normotensive healthy primigravidae.
A prospective study in which 24-h ABPM was performed on five occasions in each subject: in the first trimester between 9 and 16 weeks' gestation; in the second trimester between 18 and 24 weeks; in the third trimester between 26 and 32 weeks and between 33 and 40 weeks; and finally at 6 weeks post partum.
One hundred and six Caucasian primigravid women who were normotensive at their first booking visit were recruited consecutively from the antenatal clinic and had 24-h ABPM performed with the SpaceLabs 90207 ambulatory system.
Of the 106 women recruited, 98 completed 24-h ABPM on four of the five measurement occasions. Four women delivered prematurely before 33 weeks' gestation, thereby missing one ABPM measurement. Changes during pregnancy and the puerperium were assessed against the ABPM performed in the first trimester. There was no difference for daytime or night-time systolic blood pressure between 9 and 33 weeks, but it rose significantly from 33 to 40 weeks. At 6 weeks post partum, systolic blood pressure was not significantly different from the daytime pressure in the first-trimester ABPM but was raised significantly at night. Diastolic blood pressure decreased significantly between 18 and 24 weeks for both daytime and night-time. From 33 to 40 weeks it increased in parallel with systolic blood pressure, and at 6 weeks post partum it was raised significantly compared with first-trimester values for daytime and night-time. The nocturnal fall in blood pressure was preserved throughout pregnancy with a significant difference between daytime and night-time measurements present on all measurement occasions for systolic, diastolic and mean blood pressures and heart rate. There were significant differences between daytime ABPM and clinic blood pressure for both systolic and diastolic blood pressure up to 33 weeks. From 33 weeks until 6 weeks post partum there was no significant difference between daytime ambulatory and clinic blood pressures.
This study provides reference values for ABPM in healthy primigravidae with generally uncomplicated pregnancies.
建立血压正常的健康初产妇孕期各阶段及产褥期24小时无创动态血压监测（ABPM）的特征。
一项前瞻性研究，对每位受试者进行5次24小时ABPM：妊娠9至16周的孕早期；妊娠18至24周的孕中期；妊娠26至32周以及33至40周的孕晚期；最后在产后6周。
从产前诊所连续招募106名首次就诊时血压正常的白种人初产妇，使用太空实验室90207动态监测系统进行24小时ABPM。
在招募的106名女性中，98名在5次测量中的4次完成了24小时ABPM。4名女性在妊娠33周前早产，因此错过一次ABPM测量。根据孕早期进行的ABPM评估孕期和产褥期的变化。9至33周期间白天或夜间收缩压无差异，但从33至40周显著升高。产后6周，收缩压与孕早期ABPM的白天血压无显著差异，但夜间显著升高。白天和夜间舒张压在18至24周均显著下降。从33至40周，其与收缩压平行升高，产后6周，与孕早期白天和夜间的值相比显著升高。整个孕期夜间血压下降得以保持，收缩压、舒张压、平均血压和心率在所有测量时段白天和夜间测量值之间存在显著差异。直至33周，白天ABPM与诊所血压的收缩压和舒张压均存在显著差异。从33周直至产后6周，白天动态血压与诊所血压之间无显著差异。
本研究为妊娠一般无并发症的健康初产妇ABPM提供了参考值。
