Blood pressure changes during the first stage of labor and for the prediction of early postpartum preeclampsia: a prospective study

Eur J Obstet Gynecol Reprod Biol. 2015 Jan;184:103-7. doi: 10.1016/j.ejogrb.2014.11.020. Epub 2014 Nov 25.

Abstract

Objective: To assess systolic (SBP) and diastolic (DBP) blood pressure values during labor and to analyze their predictive value for early postpartum preeclampsia.

Study design: 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%.

Conclusion: 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.

Keywords: Blood pressure; Labor; Postpartum preeclampsia; Prediction.

MeSH terms

  • Adult
  • Blood Pressure / physiology*
  • Female
  • Humans
  • Labor Stage, First*
  • Labor, Obstetric
  • Postpartum Period*
  • Pre-Eclampsia / diagnosis*
  • Pre-Eclampsia / physiopathology
  • Pregnancy
  • Prospective Studies