Comparison of auscultatory and oscillometric automated blood pressure monitors in the setting of preeclampsia

Natarajan, Pradeep; Shennan, Andrew; Penny, J.; Halligan, Aidan; Swiet, Michael de; Anthony, John

doi:10.1016/s0002-9378(99)70109-2

Cited by 73 publications

(45 citation statements)

References 19 publications

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“…Previous investigations of automated devices in preeclampsia have revealed a tendency to under-estimate the pressure 2,3 and it is thought that haemodynamic changes associated with pre-eclampsia could account for this. Reduced arterial compliance, increased systemic vascular resistance and reduced intravascular volume may all contribute to the incorrect signal acquisition at a given pressure in the cuff.…”

Section: Discussionmentioning

confidence: 99%

“…In the latest United Kingdom Confidential Enquiry into Maternal Deaths intracranial haemorrhage was the single largest cause of death in women with pre-eclampsia and accurate blood pressure measurement is a key recommendation 1 . The inaccuracy of automated devices in pre-eclampsia is well-recognised 2,3 and gives rise to concern as mercury -acknowledged as the gold standard -is set to be eliminated from clinical use. Currently, there are more than 400 automated/aneroid devices available for blood pressure measurement 4 .…”

Section: Introductionmentioning

confidence: 99%

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Validation of the Welch Allyn 'Vital Signs' blood pressure measurement device in pregnancy and pre-eclampsia

Reinders¹

2003

BJOG: An International Journal of Obstetrics and Gynaecology

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Objective To establish the accuracy the Welch Allyn 'Vital Signs' blood pressure monitor in pregnancy and pre-eclampsia according to a modified British Hypertension Society protocol. Design Prospective observational study.Setting Maternity Unit/Obstetric Ward, Guy's and St Thomas' Hospital, London, UK.Population Forty-three pregnant women of whom 12 had pre-eclampsia.Methods Nine sequential same-arm measurements were taken from each woman by two trained observers, alternating between a mercury sphygmomanometer and the device. The last seven readings were analysed according to the British Hypertension Society protocol. The accuracy of the device was determined using the grading scale indicated by the British Hypertension Society protocol (grade A/B ¼ pass, grade C/D ¼ fail). Main outcome measures Grading criteria of the British Hypertension Society protocol.Results The Welch Allyn 'Vital Signs' monitor achieved a grade A for both systolic and diastolic pressures in pregnant women who did not have pre-eclampsia. In those women with pre-eclampsia, it achieved a grade D and B for systolic and diastolic pressures, respectively. The mean differences between the observers and the device in women without pre-eclampsia were À2.6 (6.4) mmHg and À1.5 (7.2) mmHg for systolic and diastolic pressures [and in pre-eclamptic women À7.8 (6.3) and À5.5 (6.5) mmHg]. It therefore fulfils criteria set by the Association for the Advancement of Medical Instrumentation (mean <5 mmHg and standard deviation <8 mmHg) in pregnancy, but not in pre-eclampsia. Conclusion This is the first automated device suitable for robust clinical use that can be recommended for use in pregnancy. However, it should be borne in mind that -similar to other devices -it significantly underrecorded readings obtained in pre-eclamptic women.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Validation of the Welch Allyn 'Vital Signs' blood pressure measurement device in pregnancy and pre-eclampsia

Reinders¹

2003

BJOG: An International Journal of Obstetrics and Gynaecology

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“…Monitors which are validated for general use may not be accurate in pregnancy and may give false low readings, hence specific validation in pregnant women is a must, before self-monitoring can be used routinely to monitor women with hypertension in pregnancy. 17,18 There are quite a few monitors which have been validated for home use in pregnancy using widely accepted protocols. [19][20][21][22][23] However, factors such as obesity, especially the upper arm circumference have to be taken in account when considering self-monitoring of blood pressure in pregnancy.…”

Section: Accuracy Of Self-monitoringmentioning

confidence: 99%

Self home blood pressure monitoring in pregnancy: how reliable is it?

Hemapriya

Desai

Bhandiwad

2018

Int J Reprod Contracept Obstet Gynecol

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Background: The use of automated blood pressure monitors in pregnancy has become increasingly popular, as more women tend to get involved in their healthcare. Not only does it reduce clinician visits, it also helps to eliminate the white coat hypertension.Methods: We conducted a prospective study in the antenatal department of JSS Medical College and Hospital, Mysuru; over a period of one year, from July 2016 to June 2017. The blood pressures of 50 women were recorded at four different periods of gestation using the conventional ‘Diamond mercury Sphygmomanometer’ versus the automated ‘Omron HEM 7130’ home BP monitor and compared.Results: The recordings of systolic blood pressure at home were consistently less than the office measurements at all periods of gestation. However, the difference was not statistically significant. The comparison of diastolic pressures revealed minimal variations between the mean of the office and home blood pressure recordings. The mean arterial pressure also revealed a similar trend.Conclusions: Self-monitoring of blood pressure is a feasible and acceptable option to pregnant women. It might make antenatal care more effective, but we need further research to establish safety and efficacy, the impact on women and health professionals, and how best to use the results.

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“…The Korotkoff sounds used to measure BP should be I and V (disappearance) as opposed to IV (muffling), as these are more reproducible [9] and more accurate in determining maternal diastolic BP [10]. The widespread use of automated BP apparatus in modern obstetrics is controversial as this method has been found to systematically underestimate systolic and diastolic BP in both healthy and pre-eclamptic pregnancies by 10-20 mmHg [11]. Therefore, the consideration of invasive in-patient monitoring may be warranted in severe cases of pre-eclampsia [11].…”

Section: Bp Measurement In Pregnancymentioning

confidence: 99%

“…The widespread use of automated BP apparatus in modern obstetrics is controversial as this method has been found to systematically underestimate systolic and diastolic BP in both healthy and pre-eclamptic pregnancies by 10-20 mmHg [11]. Therefore, the consideration of invasive in-patient monitoring may be warranted in severe cases of pre-eclampsia [11]. In obstetric practice, 24-h ambulatory BP monitoring is common, but its use has not been fully evaluated for maternal hypertensive disorders.…”

Section: Bp Measurement In Pregnancymentioning

confidence: 99%