DIASTOLIC BLOOD-PRESSURE IN PREGNANCY - PHASE-IV OR PHASE-V KOROTKOFFSOUNDS

Objective: To determine the magnitude of Phase IV-V diastolic blood pr essure differences in human pregnancy. Methods: Blood pressure was mea sured by a standardized technique, using a Hawkesley random zero sphyg momanometer, in 221 pregnant women. Measurements were made in the seco nd and third trimesters of pregnancy. The study included a number of w omen with chronic hypertension and a number with preeclampsia. Main Ou tcome Measures: Magnitude of Phase IV-V differences in normal and hype rtensive pregnant women. Results: As expected, values for Phase V dias tolic blood pressure were lower than for those for Phase IV both in th e second and in the third trimesters of pregnancy. In the third trimes ter, the median difference between Phase IV and V Korotkoff sounds was 5 mm Hg in normals, 7 mm Hg in chronic hypertensives, and 5 mm Hg in women with preeclampsia. Conclusion: These differences are within the error of the measurements as made in clinical practice. The smallest d ifferences were found in women with preeclampsia, who are likely to pr ovide the practitioner with the most difficult management decisions.