title: Automated blood pressure measurement devices: a potential source of morbidity in preeclampsia?
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).
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.affiliation: Department of Obstetrics and Gynaecology, University Hospital of Wales, Heath Park, Cardiff, United Kingdom.
authors.forename: M
authors.initials: M
authors.lastname: Quinn
mesh_terms: D000328:Adult; D001314:Auscultation; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000379:methods*; D015924:Blood Pressure Monitors; D005260:Female; D006801:Humans; D009991:Oscillometry; D011225:Pre-Eclampsia / Q000175:diagnosis*; D011247:Pregnancy / Q000502:physiology; D011446:Prospective Studies