Download het volledig rapport (302 p.) - KCE

KCE reports vol. 6A Prenatale zorg 55
7.3.2. Evidence tables
Klinische onderzoeken
1. Blood pressure
What are the risks associated with hypertension during pregnancy and what is the most accurate way of measurement?
Study Ref Population Intervention Outcomes Results Comments Study
Barton et
al., 2001
Page and
Christians
on,
1976
4 [515] 748 women with
a singleton
pregnancy with
hypertension in
the USA from
1995 to 1998
4 [516a] 14,833 singleton
pregnancies in
California, USA
from
1959 to 1967
Women from 24
to 35 weeks of
gestation with no
proteinuria by
dipstick (0 or
trace) at admission
to study
monitored for
progression to
proteinuria
Levels of mean
arterial
pressure in the
middle trimester
(121 to 180 days)
assessed in relation
Progression to
proteinuria
Progression to severe
pre-eclampsia
Rate of progression to
proteinuria by
gestational age at
enrolment
Incidence of SGA
babies
Stillbirth rate
Neonatal mortality
rate
Incidence of SGA
Proteinuria developed in 343/748
(46%) women
Severe pre-eclampsia developed in
72/748 (9.6%) women
Rate of progression greater in
women enrolled at less than 30
weeks compared with 34 to 35
weeks, p = 0.008
SGA in women with proteinuria
versus hypertension alone: 24.8%
vs. 13.8%, p < 0.001
Middle trimester: progressive rise
in
stillbirth and neonatal death rate
above 85 mmHg, with sharp rise
after 90 mmHg
Gestational hypertension
defined as maternal blood
pressure greater than or equal
to 140 mmHg systolic or 90
mmHg diastolic.
Proteinuria defined as greater
than or equal to 1+ (by
dipstick) on at least two
occasions.
Severe pre-eclampsia defined as
either 1) severe hypertension
(160/110 mmHg
on 2 occasions), 2) mild
hypertension with severe
proteinuria (greater than or
equal to 3+) or 3)
development of
thrombocytopenia
EL
type
CSS 3
CH 2b