Contard S, Chanudet X, Coisne D, Battistella P, Marichal J F, Pitiot M, de Gaudemaris R, Ribstein J
Hôtel-Dieu Mont-Saint-Martin, France.
Am J Hypertens. 1993 Oct;6(10):880-4. doi: 10.1093/ajh/6.10.880.
The definition of hypertensive disorders in pregnancy is plagued by many difficulties, in part related to the limits of intermittent clinic readings of blood pressure. In order to better define the evolution of arterial blood pressure in normal subjects during normal pregnancy, casual and ambulatory (Spacelabs 90207, n = 22 or Diasys 200, n = 26) measurements of blood pressure were performed at gestational months 3, 6, and 9, in 48 normal women aged 18 to 39, both nulliparas (n = 19) and multiparas (n = 29). Ambulatory blood pressure levels were lowest in the first gestational trimester (24-hour mean: 104 +/- 8/63 +/- 6 mm Hg) and rose by a small increment during the last trimester (109 +/- 8/67 +/- 7 mm Hg at 8 months). Mean daytime ambulatory pressure was almost superimposable to clinic measurements at the three time points. A day-night variation in blood pressure level was detectable in all subjects at each recording. It is concluded that during normal pregnancy, ambulatory blood pressure levels were highest in the day and lowest at night at all gestational ages and increased only minimally before the ninth month. Reference values, as defined by the percentile distribution of daytime and nighttime systolic and diastolic blood pressure, may help define more precisely an alteration in the level and/or the circadian variation of arterial blood pressure during abnormal pregnancies.
妊娠期高血压疾病的定义存在诸多困难，部分原因与血压的间歇性门诊测量的局限性有关。为了更好地界定正常妊娠期间正常受试者动脉血压的变化情况，对48名年龄在18至39岁的正常女性（初产妇19名，经产妇29名）在妊娠3个月、6个月和9个月时进行了血压的随机测量和动态血压监测（Spacelabs 90207，n = 22；或Diasys 200，n = 26）。动态血压水平在妊娠早期最低（24小时平均值：104±8/63±6 mmHg），在妊娠晚期略有升高（8个月时为109±8/67±7 mmHg）。在这三个时间点，日间动态平均血压几乎与门诊测量值重叠。在每次记录时，所有受试者均可检测到血压水平的昼夜变化。结论是，在正常妊娠期间，所有孕周的动态血压水平均白天最高，夜间最低，且在第九个月前仅略有升高。根据日间和夜间收缩压及舒张压的百分位数分布所定义的参考值，可能有助于更精确地界定异常妊娠期间动脉血压水平和/或昼夜变化的改变情况。
