Prediction of gestational hypertension or intrauterine fetal growth restriction by mid-trimester 24-h ambulatory blood pressure monitoring.

OBJECTIVES: To investigate clinical impact of 24-h ambulatory blood pressure monitoring (ABPM) on the prediction of hypertensive disorders of pregnancy and IUGR.
METHODS: ABPM was performed in 334 normotensive non-proteinuric nulliparous women at 20 weeks' gestation. Arterial blood pressure patterns were analyzed by chronobiometry.
RESULTS: Women who developed idiopathic IUGR (21) or PIH (33) showed a 24-h diastolic blood pressure mean significantly higher than the controls (69.2+/-1.8 mmHg and 73.5+/-6.2 vs. 62.2+/-1.5). Women with subsequent IUGR also showed a modification in BP rhythm. The most effective cut-off levels of 24-h diastolic blood pressure mean proved to be 67 for IUGR and 68 for hypertension.
CONCLUSIONS: ABPM in the second trimester reliably predicts idiopathic IUGR and PIH. Both patients destined to develop gestational hypertension and those destined to develop IUGR show similar elevations in 24-h diastolic mean at 20 weeks' gestation.