Conflicting views on the measurement of blood pressure in pregnancy

Article Abstract:

Routine measurement of blood pressure during pregnancy is important because pregnancy can cause blood pressure to increase. However, not all clinicians practice the same methods for measuring blood pressure and, in many cases, measurements may be inaccurate. To obtain a correct measure of blood pressure, the patient should be sitting in an upright position, the cuff should be at the same level as the heart, and the large size blood pressure cuff (the part that goes around the arm and is inflated) should be used for patients with large arms. This article describes the results of a survey designed to determine the practices of 116 midwives and 11 obstetricians working in the United Kingdom. Ninety-one responded to the questionnaire. The results of the survey showed that only 47 percent of the respondents used the method of measuring blood pressure that is recommended for pregnant women. Only 28 percent reported using the large blood pressure cuff more than twice in a four-week-period, and only 10 percent recorded blood pressure to the nearest 2 millimeters of mercury (mmHg). Twenty-three percent reported that they round off blood pressure readings to the nearest 10 mmHg. For example, this means that a blood pressure measurement of 134 would be recorded as 130, and 136 would be recorded as 140. The results of this study indicate that the recommended guidelines for measuring blood pressure in pregnant women are not followed strictly, which can lead to variable and inaccurate results. (Consumer Summary produced by Reliance Medical Information, Inc.)

Survey response rates, Medical care surveys

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Blood pressure measurement in pregnancy

Article Abstract:

Pregnant women should have their blood pressure measured each time they visit their doctor during routine prenatal check-ups. This is important for the early diagnosis of high blood pressure (hypertension), which can occur during pregnancy. The British Hypertension Society has made a series of recommendations for measuring blood pressure during pregnancy. It has become apparent that many clinicians use different techniques for measuring blood pressure, which can lead to large variations in the results obtained. For example, the size of the blood pressure cuff is very important. Although most clinicians routinely use a small cuff, the larger cuff provides a more accurate measurement of blood pressure in people with large arms. Also, the position of the patient (sitting or lying down) during the measurement is important. Lying down can cause the blood pressure to drop, making the blood pressure appear to be lower than it really is. Blood pressure should be measured with the patient sitting up and the blood pressure cuff should be at the level of the heart. The British Hypertension Society recommends that a standard technique for measuring blood pressure be developed and followed by all clinicians to reduce the number of errors in blood pressure measurement. (Consumer Summary produced by Reliance Medical Information, Inc.)

Standards, Evaluation, Prenatal care, editorial

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Automated, ambulatory, or conventional blood pressure measurement in pregnancy: which is the better predictor of severe hypertension?

Article Abstract:

Ambulatory blood pressure monitoring is a more sensitive test for hypertension in pregnancy than clinic-based monitoring. Researchers compared automated, ambulatory pressure monitoring with a series of conventional blood pressure measurements in a medical office setting in 348 pregnant women with suspected high blood pressure. Monitoring at home over a 24-hour period using an ambulatory monitor was much better at identifying women with elevated blood pressure, and less subject to misdiagnosis or incorrect technique than conventional blood pressure measurement at a medical office.

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