Langenegger E., Dalla S., Petro G., Hall D.
Department of Obstetrics and Gynaecology, Stellenbosch University, Tygerberg Academic Hospital, P.O. Box 19063, Tygerberg 7505, South Africa
Langenegger, E., Department of Obstetrics and Gynaecology, Stellenbosch University, Tygerberg Academic Hospital, P.O. Box 19063, Tygerberg 7505, South Africa; Dalla, S., Department of Obstetrics and Gynaecology, Stellenbosch University, Tygerberg Academic Hospital, P.O. Box 19063, Tygerberg 7505, South Africa; Petro, G., Department of Obstetrics and Gynaecology, Stellenbosch University, Tygerberg Academic Hospital, P.O. Box 19063, Tygerberg 7505, South Africa; Hall, D., Department of Obstetrics and Gynaecology, Stellenbosch University, Tygerberg Academic Hospital, P.O. Box 19063, Tygerberg 7505, South Africa
Objective: To compare the accuracy of two non-invasive methods of blood-pressure measurement with intra-arterial measurement in women with pre-eclampsia and acute severe hypertension. Methods: This descriptive, cross-sectional study prospectively enrolled 23 women with pre-eclampsia and acute severe hypertension for continuous intra-arterial blood-pressure monitoring. Simultaneous monitoring was performed with a manual and an automated, non-invasive device during episodes of severe hypertension. The paired T-test was used to compare measured values. The accuracy of a MAP ≥ 125 mmHg in detecting a systolic blood pressure ≥ 160 mmHg was determined. Results: There was a weak correlation between intra-arterial and automated as well as intra-arterial and manual systolic values (r = 0.34, p < 0.01; r = 0.41, p < 0.00, respectively). Better correlation was found amongst diastolic values. The differences between the mean intra-arterial (94 ± 11 mmHg) and automated (96 ± 12 mmHg) diastolic values as well as intra-arterial and manual diastolic measurements (94 ± 14 mmHg) were not significant (p = 0.20, 0.65, respectively). A mean arterial pressure ≥ 125 mmHg was not accurate in detecting a systolic value ≥ 160 mmHg, with low sensitivities (17.2-35.9%) and specificities (0-50%) for all three methods. Conclusions: When compared to intra-arterial monitoring, the automated and manual methods showed weak correlation with systolic but better correlation with diastolic values. A mean arterial pressure ≥ 125 mmHg was not accurate in detecting systolic peaks. When protection against cerebral haemorrhage is paramount, intra-arterial measurement of systolic values is best. © 2012 International Society for the Study of Hypertension in Pregnancy.Published by Elsevier B.V. All rights reserved.
accuracy; adolescent; adult; article; automation; blood pressure measurement; blood pressure monitoring; clinical article; controlled study; cross-sectional study; diastolic blood pressure; disease severity; female; human; hypertension; intermethod comparison; invasive procedure; mean arterial pressure; monitor; non invasive procedure; preeclampsia; priority journal; sensitivity and specificity; sphygmomanometer; Student t test; systolic blood pressure