Blood pressure and heart rate evaluated by ABPM in primigravid women during labor and early puerperium - Revista Brasileira de Ginecologia e Obstetrícia

Blood pressure and heart rate evaluated by ABPM in primigravid women during labor and early puerperium |

OBJECTIVE: to analyze the maternal blood pressure and heart rate variation of primigravid women during labor and early puerperium. METHODS: sixty primigravid women were included in the study, and submitted to ambulatory blood pressure monitoring (ABPM) with SpaceLabs 90207 monitor during labor and the first 12 h of puerperium. The records of blood pressure and heart rate were done every 15 min during labor and every 30 min during the first 12 h of puerperium. Three periods during labor (until cervix dilated 7 cm, cervix dilated between 8 cm and total dilatation, and delivery period) and two during puerperium (first and twelfth hours), were analyzed. First of all the results were analyzed without considering the kind of analgesia used and then the patients were divided into three groups, according to the anesthetic technique: local, lumbar extradural or subarachnoid. Results were analyzed by one-way analysis of variance (ANOVA) and paired Student's t-test for blood pressure and heart rate in each group during labor and puerperium. The nonpaired Student's t-test was used to compare different groups. A p value < 0.05 was regarded as statistically significant. RESULTS: when the results were analyzed without considering the analgesic procedure, the values of systolic blood pressure during labor were significantly higher than in early puerperium. During labor, systolic blood pressure values were higher in the periods of later cervical dilatation and delivery than during early cervical dilatation. In the 12th h of puerperium the systolic blood pressure was lower than in the first hour. Diastolic blood pressure did not change during labor and was higher than in early puerperium. Heart rate increased during labor and decreased during puerperium. The systolic and diastolic blood pressure and heart rate were the same both in local or lumbar extradural anesthesia groups; however, in the subarachnoid group the systolic and diastolic blood pressure did not change during labor. CONCLUSIONS: labor increased systolic blood pressure and heart rate. During labor, systolic and diastolic blood pressure were higher than in early puerperium. Both blood pressure and heart rate significantly fell from the first to the 12th hour of puerperium. The different anesthetic techniques did not affect blood pressure or heart rate, as compared with the primigravid group when the anesthetic technique was not taken into consideration.