[Longitudinal study of 24-hour blood pressure behavior in pregnancy and puerperium in patients with normal pregnancy, pre-eclampsia and HELLP syndrome]

Ante- and postpartum noninvasive 24-hour ambulatory blood pressure measurements were performed in 18 normotensive pregnants and 36 patients with mild (n = 16) or severe preeclampsia (n = 12) or HELLP-syndrome (n = 8). In contrast to normotensive pregnancy (n = 18) displaying a decline of systolic and diastolic blood pressure in comparison with normotensive non-pregnant, preeclamptic women demonstrate significantly elevated blood pressure profiles before delivery that remain elevated up to the eighth week postpartum. 9 out of 12 patients with severe preeclampsia and 6 of 8 women with HELLP-syndrome show a nocturnal increase of blood pressure within the first week postpartum and a non-dipping up to the eighth week after delivery. As a result of this, in preeclamptic women blood pressure control should be extended into the night and antihypertensive therapy should include a sufficient evening dose.