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Ambulatory blood pressure monitoring in pregnancy

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Author(s): Marlene Sousa

Journal: Acta Obstetrica e Ginecologia Portuguesa
ISSN 1646-5830


ABSTRACT
Introduction: Ambulatory blood pressure monitoring (ABPM) in pregnancy may facilitate the diagnosis of hypertension and pre-eclampsia, leading to better management of the disease.Aim: To assess if the use of ABPM during pregnancy improves maternal and fetal outcomes when compared with conventional blood pressure measurement.Methods: The UpToDate, Clinical Evidence, EBM Journal, Trip Database, Cochrane Library, DARE, Bandolier, National Guideline Clearinghouse, Guidelines Finder, Medline, and Índex da Revistas Médicas Portuguesas databases were searched for articles written in English, Spanish, French or Portuguese, published between January 1998 and June 2009, using MeSH terms "Blood Pressure Monitoring, Ambulatory and Pregnancy". References selected by hand from relevant articles were also included. The Strenght of Recomendation (SOR) taxonomy was used to assess the quality of the articles and to produce recommendations.Results: Two systematic reviews (SRs), five clinical trials (CTs), and six guidelines were reviewed. SRs point to a lack of evidence for the use of ABPM in blood pressure monitoring during pregnancy and prediction of pre-eclampsia. CTs support the use of ABPM for the diagnosis of white coat hypertension in healthy pregnant women. Published guidelines are in agreement with these results. Discussion/Conclusion: There is no evidence for the use of ABPM in blood pressure monitoring during pregnancy or in prediction of pre-eclampsia (SOR A). ABPM appears to be useful in the diagnosis of white coat hypertension in healthy pregnant women (SOR B). There is a need for randomized controlled trials addressing the use of ABPM in pregnancy.
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