AMBULATORY BLOOD-PRESSURE MEASUREMENT IN PREGNANCY - THE CURRENT STATE-OF-THE-ART

Blood pressure measurement is one of the most frequently used screenin g tests in pregnancy. However, conventional blood pressure measurement has several shortcomings; it provides a measurement that represents o nly a fraction of the 24-h blood pressure profile, usually under circu mstances that may have a presser effect, and the technique is fraught with potential errors. In the nonpregnant population the development o f devices capable of accurately measuring 24-h blood pressure noninvas ively is proving valuable in predicting the cardiovascular complicatio ns of hypertension. It is likely that this technique will also prove u seful in pregnancy. Validation in pregnancy of such monitoring techniq ues should precede any widespread application. Reference values using oscillometric monitors are now available for 24-h ambulatory blood pre ssure measurement in pregnancy. Provisional data suggest that ambulato ry blood pressure measurement could overcome the large sampling, measu rement, and ''white coat hypertension phenomenon'' errors associated w ith conventional measurement. In addition, changes in the diurnal rhyt hm of blood pressure may have diagnostic significance in the predictio n of preeclampsia. Outpatient monitoring using 24-h ambulatory blood p ressure devices may reduce the need for inpatient assessment, which ha s very considerable implications in terms of cost and patient satisfac tion.