MEASURING BLOOD-PRESSURE IN PREGNANT-WOMEN - A COMPARISON OF DIRECT AND INDIRECT METHODS

被引:44
作者
BROWN, MA
REITER, L
SMITH, B
BUDDLE, ML
MORRIS, R
WHITWORTH, JA
机构
[1] ST GEORGE HOSP, DEPT MED, SYDNEY, NSW, AUSTRALIA
[2] ST GEORGE HOSP, DEPT ANESTHESIA, SYDNEY, NSW, AUSTRALIA
[3] UNIV NEW S WALES, SYDNEY, NSW, AUSTRALIA
[4] HURTSVILLE COMMUNITY HOSP, DEPT OBSTET, SYDNEY, NSW, AUSTRALIA
关键词
BLOOD PRESSURE; INTRAARTERIAL RECORDINGS; KOROTKOFF SOUNDS; SPHYGMOMANOMETRY; DIASTOLIC PRESSURE;
D O I
10.1016/0002-9378(94)90079-5
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
OBJECTIVES: Our goals were to determine (1) whether Korotkoff phase IV or V sound was a more accurate measure of diastolic blood pressure in pregnancy and (2) interobserver variability of mercury sphygmomanometry of pregnant women. STUDY DESIGN: Direct (intraarterial) and indirect (mercury sphygmomanometry) blood pressures were compared in 28 pregnant women. Interobserver variability was assessed in a separate study of 86 pregnant women using four highly trained observers. RESULTS: (1) Routine sphygmomanometry underestimated direct systolic pressure by 11 (3, 18) mm Hg, p < 0.001 (median, interquartile range of differences). Phase IV Korotkoff sound overestimated direct diastolic pressure by 9 (2, 12) mm Hg (p < 0.001) and phase V by 4 (2, 7) mm Hg (p = 0.04). Phase V-recorded diastolic pressure was closer to direct diastolic pressure significantly more often (75%) than was phase IV-recorded diastolic pressure (21%) (p = 0.003). Mean arterial pressures did not differ significantly according to the method used. (2) Median blood pressures did not differ among the four observers for systolic, diastolic phase IV, or phase V recordings. Maximum difference for blood pressure recording among observers was 4 (2, 6) mm Hg. CONCLUSIONS: Auscultatory sphygmomanometry in pregnant women underestimates systolic and overestimates diastolic blood pressure, but the phase V Korotkoff sound is more likely to represent the true diastolic pressure than is the phase IV sound.
引用
收藏
页码:661 / 667
页数:7
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