Research Article

Ambulatory Blood Pressure Monitoring for Hypertension Diagnosis in Pregnancy: A Prospective Study in Saint-Louis, Senegal

Authors: BEYE SM, THIAM O, SARR CCT, DIOP NR, SOW DB, TRAORE YF, SY JBM, KANE AD.

DOI: 10.33425/2639-8486.1214

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Abstract

Background: Hypertensive disorders in pregnancy affect 10-15% of pregnancies and account for 30% of maternal deaths and 20% of fetal mortality. Accurate blood pressure measurement is crucial for early diagnosis and management.

Objective: To evaluate the utility of 24-hour ambulatory blood pressure monitoring (ABPM) in diagnosing hypertension during pregnancy compared to conventional clinic measurements.

Methods: This prospective longitudinal study was conducted from July to December 2018 at the Regional Hospital Center of SaintLouis, Senegal. Pregnant women ≥20 weeks’ gestation were included. Clinic blood pressure measurements during prenatal visits were compared with 24-hour ABPM results.

Results: Thirty-one pregnant women were enrolled (mean age 32±5.9 years, 72% in third trimester). ABPM revealed hypertension in 9.7% (systolic) and 3.2% (diastolic) of patients over 24 hours. Clinic measurements detected systolic hypertension in only 6% at first prenatal visit. Among systolic hypertension cases detected by ABPM, 38% were masked hypertension (normal clinic BP, elevated ABPM). All diastolic hypertension cases were masked. Conversely, 50% of patients with elevated clinic BP were normotensive on ABPM (white-coat hypertension). Nocturnal hypertension was found in 25.8% (systolic) and 3.2% (diastolic) of patients. Fifty-two percent of patients were non-dippers.

Conclusion: ABPM detected significant masked hypertension (38% systolic, 100% diastolic) and white-coat hypertension (50%) unidentified by clinic measurements. These findings suggest ABPM could improve hypertension diagnosis accuracy in pregnancy, potentially preventing both under-treatment and over-treatment.

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