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18 - Measuring blood pressure in pregnancy and pre-eclampsia

from Part II - Clinical Practice

Published online by Cambridge University Press:  03 September 2009

By
Andrew H. Shennan  and
Annemarie De Greeff
Edited by
Fiona Lyall  and
Michael Belfort
Fiona Lyall
Affiliation:
University of Glasgow
Michael Belfort
Affiliation:
University of Utah
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Summary

Introduction

Blood pressure is measured routinely during the antenatal period. Accurate blood pressure measurement is essential to the diagnosis and management of hypertension in pregnancy. The gold standard for measuring indirect blood pressure is the mercury sphygmomanometer, although it is widely acknowledged that it has associated errors and that alternatives are not dependent on the skill of the observer, which can have significant advantages.

One such alternative is automated equipment. However, the inherent inaccuracies of most automated devices are confounded by the altered hemodynamic state of pregnancy and especially pre-eclampsia. Evidence already points to significant inaccuracies in women with pre-eclampsia. However, as most of these devices are intended for home monitoring they have the potential to reduce inpatient monitoring whilst improving surveillance. The role of this type of monitoring is yet to be to established.

It is of critical importance that these devices are evaluated according to a recognized protocol, i.e. the British Hypertension Society, the European Society of Hypertension or the Association for the Advancement of Medical Instrumentation, before their accuracy in clinical practice, and especially an obstetric population, can be assumed.

Accurate and precise technique and the use of properly calibrated and well-maintained equipment is vital.

The importance of blood pressure in pregnancy

The importance of blood pressure measurement during pregnancy has been recognized for more than a century (Seligman, 1987) and is a fundamental part of antenatal care.

Type
Chapter
Information
Pre-eclampsia
Etiology and Clinical Practice
 , pp. 258 - 275
Publisher: Cambridge University Press
Print publication year: 2007

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