Blood Pressure Measurement In Pregnancy Research Articles

Blood pressure measurement in pregnancy.

BJOG: An International Journal of Obstetrics & GynaecologyVolume 103, Issue 9 p. 862-863 Blood pressure measurement in pregnancy Michael de Swiet, Michael de Swiet Consultant Physician Andrew Shennan, Senior Registrar Lecturer Institute of Obstetrics and Gynaecology, Queen Charlotte's and Chelsea Hospital, LondonSearch for more papers by this author Michael de Swiet, Michael de Swiet Consultant Physician Andrew Shennan, Senior Registrar Lecturer Institute of Obstetrics and Gynaecology, Queen Charlotte's and Chelsea Hospital, LondonSearch for more papers by this author First published: September 1996 https://doi.org/10.1111/j.1471-0528.1996.tb09902.xCitations: 18Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume103, Issue9September 1996Pages 862-863 RelatedInformation

Indirect blood pressure measurement in pregnancy

Indirect blood pressure measurement in pregnancy

Measurements of Blood Pressure, Oedema and Proteinuria in a Pregnant Population of New Zealand

This is the first report of the largest study of blood pressure measurement in pregnancy in a New Zealand population using standardized definitions and methodology. Over 3,800 women who delivered in an 8-month period in the Wellington region were included in the study. Blood pressure measurement and the presence of oedema and proteinuria were recorded from booking until delivery and in the puerperium. Only 2.7% of women were unable to be contacted after delivery for details on outcomes. The results established normal ranges for blood pressure throughout pregnancy. The data show that blood pressure greater than 140/90 until 35 weeks' gestation is outside 2 standard deviations at all gestations and justifies using these measurements as the definition of hypertension in pregnancy. The fall in blood pressure in the 2nd trimester was less than 1 mm Hg per week in both the systolic and diastolic pressures. This fall was smaller than previously recorded in other studies. Gestational hypertension was the commonest blood pressure abnormality occurring in 15.2% of the population. This represented 69% of the pregnant women with a hypertensive disorder. The overall incidence of both gestational hypertension and preeclampsia was 18.5% which is higher than reported in other parts of the world. In this study obesity was significantly associated with hypertensive disorders in pregnancy. An arm circumference of > 33 cm, one of the measurements of obesity, was found in 6.8% of the study population. Even after the effect of arm circumference was taken into account, hypertensive disorders were also more common in Pacific Island women.(ABSTRACT TRUNCATED AT 250 WORDS)

Ambulatory Blood Pressure Measurement in Pregnancy: the Current State of the Art

Blood pressure measurement is one of the most frequently used screening tests in pregnancy. However, conventional blood pressure measurement has several shortcomings; it provides a measurement that represents only a fraction of the 24-h blood pressure profile, usually under circumstances that may have a pressor effect, and the technique is fraught with potential errors. In the nonpregnant population the development of devices capable of accurately measuring 24-h blood pressure noninvasively is proving valuable in predicting the cardiovascular complications of hypertension. It is likely that this technique will also prove useful in pregnancy. Validation in pregnancy of such monitoring techniques should precede any widespread application. Reference values using oscillometric monitors are now available for 24-h ambulatory blood pressure measurement in pregnancy. Provisional data suggest that ambulatory blood pressure measurement could overcome the large sampling, measurement, and “white coat hypertension phe...

Ambulatory blood pressure measurement in pregnancy

Ambulatory blood pressure measurement in pregnancy

Indirect blood pressure measurement in pregnancy: Korotkoff phase 4 versus phase 5

Controversy exists regarding which Korotkoff phase should be used to estimate diastolic blood pressure during pregnancy, some authorities recommending phase 5 (disappearance of sounds) and others suggesting phase 4 (muffling). Available data indicate that Korotkoff phase 5 more closely approximates true intraarterial diastolic pressure in pregnant women. Nonetheless, it has been suggested that phase 5 is unmeasurable in a significant number of gravid women, making this end point less desirable. However, studies examining this issue indicate that Korotkoff phase 5 is determinable in more than 90% of gravid women and that the incidence of an indeterminable phase 4 is at least as great as that for phase 5. Moreover, there appears to be greater observer variability in the measurement of phase 4 compared with phase 5. We conclude that available evidence supports recommendations for the use of Korotkoff phase 5 as the preferred end point to estimate diastolic blood pressure during pregnancy. In those few patients having very low or indeterminate phase 5 determinations, both phase 4 and phase 5 should be recorded and the former used to guide patient management. An alternative strategy is to record both phases in all gravid women beginning at the first prenatal visit so that baseline phase 4 values are available in the event that phase 5 becomes indeterminate.

Conflicting views on the measurement of blood pressure in pregnancy

Current practice with regard to the technique of blood pressure measurement in pregnancy was assessed by means of a self-completed questionnaire sent to all midwives (116) and obstetricians (11) working in a UK District General Hospital obstetric unit. The response rate was 72% (91 respondents). Over half of the respondents (53%) use the fifth phase diastolic end point (contrary to current recommendations). Of the 75 respondents who had access to a large adult cuff 54 (72%) had used it on 'less than two occasions' over the preceding four weeks. Only 10% (9) of respondents reported that they record blood pressure to the nearest 2 mmHg and 23% (22) reported that they round blood pressure readings to the nearest 10 mmHg. There were diverse views on the interpretation of multiple blood pressure recordings. The conclusion is that compliance with current recommendations on blood pressure measurement technique in pregnancy is poor. There is poor agreement among midwives and obstetricians as to how blood pressure should be recorded in pregnancy.

Blood pressure measurement in pregnancy

Blood pressure measurement in pregnancy

No difference between home and clinic blood pressure measurements in pregnancy: A computerized telemetric study

Many decisions in pregnancy are based on one or two casual blood pressure estimations made in the antenatal clinic. No previous study has challenged the validity of this practice or attempted to discover whether there are significant differences between the blood pressures of pregnant women when they are measured in the clinic and when they are measured in their home environment. We measured the blood pressures of 35 healthy pregnant women both at the antenatal clinic and in their own homes. All the women were at between 28 and 32 weeks gestation. At both locations, ten consecutive blood pressure and pulse measurements were made at one minute intervals using a Dinamap 1846P automated blood pressure monitor. The readings taken in the clinic were supervised, whilst at home the patients used our blood pressure telemetry system without direct supervision, the results being transmitted automatically to the hospital computer via the public telephone network. The Dinamap results were analysed in detail. Each ten minute recording session was summarised in terms of the first, last, highest, lowest and mean of the systolic, diastolic and mean arterial blood pressure, and pulse measurements in that session. Also, two measures of the variability within a ten measurement series were considered, the average change in pressure or pulse from one reading to the next, and the difference between the highest and lowest readings of pressure and pulse in the series. All descriptors of the clinic and the home measurements were compared using the paired Student's t-test. Clinic and home blood pressure measurements were not significantly different from each other in any respect.(ABSTRACT TRUNCATED AT 250 WORDS)

The influence of different positions and Korotkoff sounds on the blood pressure measurements in pregnancy.

The influence of the patient's posture on the measurement of arterial blood pressure has been studied during pregnancy. The blood pressure (BP) measured on the right arm in the left lateral recumbent position is significantly lower than in the supine, sitting, or erect positions. This difference is assumed to be due to hydrostatic factors. The diastolic BP should be read off at Korotkoff IV because the hyperkinetic circulation during pregnancy causes a pronounced variation in BP values when measurements are performed at Korotkoff sound V. The roll-over test seems inappropriate as a screening test to predict pre-eclampsia, because of the numerous false-positive tests. The importance of measuring the BP under standardized conditions during pregnancy in order to detect minimal changes in BP as indicative of pathophysiology in pre-eclampsia is emphasized.