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Mind the Evidence Gap: Lack of Validated Blood Pressure Devices for Pregnant Patients
Aleena Sajid1, Lisa Dubrofsky2, Shital Gandhi3
1Temerty Faculty of Medicine, University of Toronto, Toronto, ON.
Abstract:
Blood pressure measurement is essential for diagnosing hypertensive disorders in pregnancy, yet many automated monitors in Canada lack pregnancy-specific validation. Pregnancy causes cardiovascular changes that may affect the accuracy of oscillometric devices. Despite this limitation, it remains unclear which automated devices used in clinics and at home are validated for pregnancy, and many monitors may be used without confirmed validation. Hypertension Canada guidelines acknowledge this gap in blood pressure assessment during pregnancy. Evidence shows automated devices can produce clinically meaningful inaccuracies, leading to under- or overdiagnosis of hypertensive disorders of pregnancy. Addressing this issue requires pregnancy-specific validation studies, regulatory attention, and increased clinical awareness to ensure accurate and equitable maternal care.
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Errors occurring during blood pressure monitoring
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Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Equipments Used To Measure Blood Pressure
This invasive approach involves cannulating a peripheral artery. During each cardiac contraction, pressure generates mechanical motion within the catheter, transmitted through rigid, fluid-filled tubing to a transducer. This transducer converts mechanical motion into electrical signals displayed as waveforms on a monitor. An automatic flushing system prevents blood backflow. Due to the potential risk of unexpected arterial blood loss, this method is primarily used in intensive...
Pre-Procedural Guidelines for Assessing Blood Pressure
Measurement of Blood Pressure
Assessment of blood pressure in brachial artery(one-step method)
Prepare for the Procedure: