COMPARISON OF AN AUSCULTATORY VERSUS AN OSCILLOMETRIC AMBULATORY BLOOD-PRESSURE MONITOR IN NORMOTENSIVE, HYPERTENSIVE, AND PREECLAMPTIC PREGNANCY

Objective: To compare the accuracy of the auscultatory profilomat ambu latory blood pressure monitor and the oscillometric SpaceLabs 90207 in pregnant women.Methods: Evaluation of study devices was performed acc ording to the device validation protocol of the British Hypertension S ociety. Both study devices were compared with standard mercury sphygmo manometry in one single group of 55 pregnant women, of whom 21 were no rmotensive, 22 had mild hypertension, and 12 mild preeclampsia. Result s: The mean differences (SD) between observers and SpaceLabs 90207 wer e -3(6) mmHg for systolic pressure, 13(7) mmHg for Korotkoff phase 4 d iastolic pressure and 4(7) mmHg for Korotkoff phase 5 diastolic pressu re. The mean differences (SD) between observers and Profilomat were 3( 4) mmHg for systolic pressure, 10(6) mmHg for phase 4 diastolic pressu re, and 4(7) mmHg for phase 5 diastolic pressure. Both devices achieve d BHS grades B, D, and C for systolic, phase 4 diastolic, and phase 5 diastolic pressures, respectively. However, 95% limits of agreement be tween observers and study device were wide for both SpaceLabs 90207 an d Profilomat. Phase 5 diastolic pressure differences between observers and both study devices were significantly greater in hypertensive wom en compared to normotensive women. Conclusions: The auscultatory Profi lomat monitor is as accurate as the oscillometric SpaceLabs 90207 in n ormotensive pregnant women, and in pregnant women with mild hypertensi on or mild preeclampsia. Our results do not allow conclusions on accur acy in women with severe hypertension or severe preeclampsia. For both devices, differences from mercury sphygmomanometry can be large in in dividual pregnant women, and increase with level of blood pressure.