M Quinn1. 1. Department of Obstetrics and Gynaecology, University Hospital of Wales, Heath Park, Cardiff, United Kingdom.
Abstract
OBJECTIVE: The purpose was to compare auscultatory and oscillometric techniques in the determination of maternal blood pressure in normotensive primigravid patients and primigravid patients with proteinuric preeclampsia (blood pressure > 140/90 on two occasions and proteinuria > 0.5 gm/L). STUDY DESIGN: A prospective comparison of systolic and diastolic blood pressure was made with an automated device using oscillometric principles and two observers using a double-headed stethoscope to determine auscultatory observations (phase I and phase IV of the vascular sounds) in normotensive primigravid patients (N = 40) and primigravid patients with proteinuric hypertension (N = 17). RESULTS: In patients with proteinuric preeclampsia the mean differences between auscultatory (phase I and phase IV) and oscillometric observations were 5.4 mm Hg (SEM 1.4 mm, p < 0.05) and 14.8 mm Hg (SEM 2.9 mm, p < 0.01) for systolic and diastolic observations, respectively. In normotensive patients the mean differences between auscultatory (phase I and phase IV) and oscillometric observations were 2.4 mm Hg (SEM 0.9 mm, p not significant) and 7.5 mm Hg (SEM 1.9 mm, p < 0.01) for systolic and diastolic observations, respectively. CONCLUSION: Automated devices using oscillometric principles "underrecord" systolic and diastolic blood pressure compared with auscultatory observations (phase I and phase IV) in patients with proteinuric preeclampsia. In some cases the difference between observations exceeds 30 mm Hg.
OBJECTIVE: The purpose was to compare auscultatory and oscillometric techniques in the determination of maternal blood pressure in normotensive primigravid patients and primigravid patients with proteinuric preeclampsia (blood pressure > 140/90 on two occasions and proteinuria > 0.5 gm/L). STUDY DESIGN: A prospective comparison of systolic and diastolic blood pressure was made with an automated device using oscillometric principles and two observers using a double-headed stethoscope to determine auscultatory observations (phase I and phase IV of the vascular sounds) in normotensive primigravid patients (N = 40) and primigravid patients with proteinuric hypertension (N = 17). RESULTS: In patients with proteinuric preeclampsia the mean differences between auscultatory (phase I and phase IV) and oscillometric observations were 5.4 mm Hg (SEM 1.4 mm, p < 0.05) and 14.8 mm Hg (SEM 2.9 mm, p < 0.01) for systolic and diastolic observations, respectively. In normotensive patients the mean differences between auscultatory (phase I and phase IV) and oscillometric observations were 2.4 mm Hg (SEM 0.9 mm, p not significant) and 7.5 mm Hg (SEM 1.9 mm, p < 0.01) for systolic and diastolic observations, respectively. CONCLUSION: Automated devices using oscillometric principles "underrecord" systolic and diastolic blood pressure compared with auscultatory observations (phase I and phase IV) in patients with proteinuric preeclampsia. In some cases the difference between observations exceeds 30 mm Hg.
Authors: Natalie A Bello; Jonathan J Woolley; Kirsten Lawrence Cleary; Louise Falzon; Bruce S Alpert; Suzanne Oparil; Gary Cutter; Ronald Wapner; Paul Muntner; Alan T Tita; Daichi Shimbo Journal: Hypertension Date: 2017-12-11 Impact factor: 10.190