The value of the mean arterial blood pressure in the second trimester (MAP-2 value) as a predictor of pregnancy-induced hypertension and preeclampsia. A preliminary report.

Abstract

In 200 healthy nulliparous women the mean arterial blood pressure in the second trimester (MAP-2 value) was calculated. 85 women (42 %) had a MAP-2 value of greater than or equal to 90 mmHg (positive test result), but only 27 women (32 %) developed a hypertensive complication. Conversely, 113 of the 115 (98 %) women with a negative test result (MAP-2 value less than 90 mmHg) remained normotensive. Only two women of this group (2 %) later showed a mild pregnancy-induced hypertension. Thus, the MAP-2 value has a high sensitivity (93 %) and a high predictive value of negative test results (98 %). On the other hand, there is a high rate of false-positive results (68 %) and thus a low predictive value of positive test results (32 %). It is concluded that the MAP-2 value is a simple method for selecting pregnant women who should be examined with other more specific predictive tests. Alternatively, weekly measurements of blood pressure are recommended for early diagnosis of hypertensive disorders of late pregnancy in all women with a MAP-2 value of 90 mmHg or more.