Blood pressure measurement by oscillometric and auscultatory methods in normotensive pregnant women

Vigato, Estefanie Siqueira; Lamas, José Luiz Tatagiba

doi:10.1590/0034-7167-2018-0314

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Revista Brasileira de Enfermagem

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Sumário

ORIGINAL ARTICLE • Rev. Bras. Enferm. 72 (suppl 3) • Dec 2019 • https://doi.org/10.1590/0034-7167-2018-0314 copy

Blood pressure measurement by oscillometric and auscultatory methods in normotensive pregnant women

Evaluación de la presión arterial por los métodos oscilométrico e auscultatorio en embarazadas normotensas

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to compare blood pressure values obtained by auscultatory and oscillometric methods in different gestational periods, considering cuff width.

Method:

it is a cross-sectional and quasi-experimental study approved by the Research Ethics Committee. The sample consisted of 108 low-risk pregnant women. Blood pressure measurements were performed in gestational periods of 10-14, 19-22 and 27-30 weeks.

Results:

The oscillometric device presented values similar to the auscultatory method in systolic blood pressure, but overestimated diastolic blood pressure. Underestimation of blood pressure occurred when using the standard width cuff rather than the correct width cuff in both measuring methods.

Conclusion:

Verification of brachial circumference and use of adequate cuffs in both methods are indispensable to obtain reliable blood pressure values in pregnant women. We recommend performance of additional studies to evaluate diastolic blood pressure overestimation by the Microlife 3BTO-A.

Descriptors:
Pregnancy; Arterial Pressure; Pregnancy-induced Hypertension; Blood Pressure Monitors; Blood Pressure Measurement

Cuff Width (cm)	Group 1		Group 2		Group 3		Total	% (Total)	C
Cuff Width (cm)	n	%	n	%	n	%	Total	% (Total)	C
9	1	2.80	1	2.80	2	5.60	4	3.70	3.70
10	6	16.70	9	25.00	3	8.30	18	16.70	20.40
11	13	36.10	7	19.40	8	22.20	28	25.90	46.30
12	7	19.40	13	36.10	15	41.70	35	32.40	78.70
13	7	19.40	4	11.10	5	13.90	16	14.80	93.50
14	1	2.80	2	5.60	2	5.60	5	4.60	98.10
15	1	2.80	0	00.00	1	2.80	2	1.90	100.00

Variable	Methods	Cuff	Mean (SD)	Minimum	Median	Maximum
Systolic blood pressure	AUSC	SWC	101.32^* * significant difference between auscultatory method with CWC and auscultatory method with SWC (p<0.0001, GEE model); ^† † significant difference between auscultatory method with SWC and oscillometric 1 (p<0.025, GEE model); (8.09)	82.00	100.50	120.00
	OSC 1	SWC	102.57 (8.42)	79.00	102.00	122.00
	AUSC	CWC	104.81^‡ ‡ significant difference between auscultatory method with CWC and oscillometric 2 (p<0.002, GEE model). (7.55)	86.00	105.00	127.00
	OSC 2	SWC	102.93 (9.02)	78.00	103.00	123.00
Diastolic blood pressure	AUSC	SWC	55.45^* * significant difference between auscultatory method with CWC and auscultatory method with SWC (p<0.0001, GEE model); ^† † significant difference between auscultatory method with SWC and oscillometric 1 (p<0.025, GEE model); (9.53)	30.00	56.00	77.00
	OSC 1	SWC	63.89 (7.13)	40.00	63.00	82.00
	AUSC	CWC	57.19^‡ ‡ significant difference between auscultatory method with CWC and oscillometric 2 (p<0.002, GEE model). (8.55)	38.00	58.50	78.00
		SWC	64.31 (6.60)	47.00	63.00	80.00

Group	Method	Cuff	Mean (SD)	Minimum	Median	Maximum
1	AUSC	SWC	98.86*^† † significant difference between auscultatory method with SWC and oscillometric 1 (p<0.0403, GEE model); (8.00)	84.00	98.50	119.00
	OSC 1	SWC	101.14 (7.28)	83.00	101.00	122.00
	AUSC	CWC	102.06 (7.60)	86.00	100.50	119.00
	OSC 2	SWC	101.58 (8.62)	86.00	101.00	123.00
2	AUSC	SWC	101.14^* * significant difference between auscultatory method with CWC and auscultatory method with SWC (p<0.0001, GEE model); (8.18)	82.00	101.00	118.00
	OSC 1	SWC	101.53 (8.98)	79.00	103.00	117.00
	AUSC	CWC	105.25^‡ ‡ significant difference between auscultatory method with CWC and oscillometric 2 (p<0.0002, GEE model). (7.26)	92.00	104.50	117.00
	OSC 2	SWC	101.72 (9.16)	78.00	102.50	121.00
3	AUSC	SWC	103.97^* * significant difference between auscultatory method with CWC and auscultatory method with SWC (p<0.0001, GEE model); (7.46)	90.00	103.00	120.00
	OSC 1	SWC	105.06 (8.57)	90.00	103.00	122.00
	AUSC	CWC	107.14 (7.09)	95.00	106.50	127.00
	OSC 2	SWC	105.47 (8.97)	89.00	105.50	123.00

Group	Method	Cuff	Mean (SD)	Minimum	Median	Maximum
1	AUSC	MLP	58.47^* * significant difference between auscultatory method with CWC and auscultatory method with SWC (p<0.004, GEE model); ^† † significant difference between auscultatory method with SWC and oscillometric 1 (p<0.0001, GEE model); (9.07)	40.00	60.00	77.00
	OSC 1	MLP	64.47 (6.26)	51.00	64.50	81.00
	AUSC	MLC	60.39^‡ ‡ significant difference between auscultatory method with CWC and oscillometric 2 (p<0.0001, GEE model). (7.47)	41.00	60.50	78.00
	OSC 2	MLP	65.03 (6.64)	52.00	64.50	80.00
2	AUSC	MLP	53.86^* * significant difference between auscultatory method with CWC and auscultatory method with SWC (p<0.004, GEE model); ^† † significant difference between auscultatory method with SWC and oscillometric 1 (p<0.0001, GEE model); (8.32)	35.00	54.50	69.00
	OSC 1	MLP	62.94 (7.03)	40.00	63.00	82.00
	AUSC	MLC	56.31^‡ ‡ significant difference between auscultatory method with CWC and oscillometric 2 (p<0.0001, GEE model). (7.20)	41.00	56.00	69.00
	OSC 2	MLP	63.72 (5.67)	52.00	63.00	76.00
3	AUSC	MLP	54.03^† † significant difference between auscultatory method with SWC and oscillometric 1 (p<0.0001, GEE model); (10.58)	30.00	54.00	76.00
	OSC 1	MLP	64.25 (8.08)	49.00	63.00	80.00
	AUSC	MLC	54.89^‡ ‡ significant difference between auscultatory method with CWC and oscillometric 2 (p<0.0001, GEE model). (9.94)	38.00	54.00	76.00
	OSC 2	MLP	64.17 (7.49)	47.00	63.00	80.00

Variable	Method	Cuff used	Comparison	MD	95%CI
SBP	AUSC	SWC	13 - 9 ou 10	8.37	3.33 - 13.41
	AUSC	SWC	13 - 11	5.76	1.50 - 10.02
	OSC 1	SWC	13 - 9 ou 10	8.74	2.57 - 14.92
	OSC 2	SWC	13 - 9 ou 10	9.20	2.95 - 15.45
DBP	AUSC	SWC	13 - 9 ou 10	9.44	3.71 - 15.17
	OSC 1	SWC	13 - 9 ou 10	5.34	0.66 - 10.01
		SWC	13 - 9 ou 10	5.93	2.16 - 9.70

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[1] Corresponding Author: Estefanie Siqueira Vigato. E-mail: estefanievigato@gmail.com