Continuous versus Intermittent Blood Pressure Monitoring in Postpartum Preeclampsia with Severe Features.

Abstract

In this study, we piloted the use of continuous 24-hour blood pressure (BP) monitoring in postpartum patients with preeclampsia with severe features. We measured continuous BP for up to 24 hours using finger plethysmography. We also used an oscillometric device to measure brachial BP per usual clinical protocol (intermittent BP) during the same monitoring period. Using a paired t-test, we compared mean BP values assessed using intermittent and continuous methods and, using McNemar's test, we compared the proportion of patients with sustained severe range BP using each BP measurement method. A total of 25 patients were included in this study. There was no difference in mean systolic BP (SBP) and mean arterial pressure between intermittent and continuous BP measurements. Intermittently recorded mean diastolic BP (DBP) was significantly higher than continuously recorded DBP. Eleven participants (44%) had sustained SBP ≥160 mmHg using continuous monitoring compared to 2 using intermittent monitoring (p=0.003) and of these 11 participants, 3 (37%) also had recorded sustained DBP ≥ 110 mmHg using continuous monitoring compared to none using intermittent monitoring. Continuous BP monitoring is a feasible and reliable method for detecting sustained severe range BP in postpartum patients receiving treatment for preeclampsia with severe features.