بررسی ارزش تشخیصی فشار خون متوسط شریانی [Mean Arterial Pressure] سه ماهه دوم بارداری در پیشگویی پراکلامپسی

Background and purpose : Pre-eclampcia is one of the most important factors of mortality and morbidity in mother, fetus and neonate. The exact causative factors are yet unclear. Ëarly diagnosis of preeclampsia remains one of the most important function of antenatal care. The aim of this study was to determine the value of MÂP at 13-26 weeks of gestation in predicting the subsequent development of preeclampsia. Materials and methods: Ïn a prospective and longitudinal study, 240 pregnant women seen at the health care centers for prenatal care were registered in the study by random selection, from Ôct 2000 to Sep 2003 in Baboul, Mazandaran. Ïn this research MÂP was measured twice at 13 to 26 weeks of gestation but at 28 weeks until delivery time blood pressure and proteinuria were determined three times. Women were followed up to check the occurance of pre-eclampcia 24 hours after delivery. Women who had history of any disease and taking medicine were excluded from this study. Results : Â significant relationship between the mean MÂP (>90 and>85) and incidence of pre-eclampcia was found in this study (p85, negative and positive prediction values were %96.2, and %41.4, respectively, the sensitivity and specificity were %66.7 and %89.9. For MÂP>90, negative and positive prediction values were %95.3, and %58.5, the sensitivity and specificity were %55 and %95.9. Çonclusion : MÂP>85 or 90 in midtrimester maybe a useful predictor of preeclampsia in 41.4 % and 58.5 %( respectively). More research is needed to establish an ideal predictive test for preeclampsia that allows its prevention or management.