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Clinical Trial
. 2024 Aug 1;29(4):167-172.
doi: 10.1097/MBP.0000000000000700. Epub 2024 Mar 5.

A comparison among oscillometric waveforms in healthy nonpregnant women, pregnancy and hypertensive disorders of pregnancy

Jennifer S Ringrose  1   2 , Sangita Sridar  1 , Patricia Araneta  1 , Lillian Chan  1 , Jalisa Kassam  1 , Mira Wirzba  3 , Kate Greeff  4 , Gillian Ramsay  1 , Winnie Sia  1 , Rshmi Khurana  1   2   4 , Erin Bader  4 , Raj Padwal  1   2
Affiliations
Clinical Trial

A comparison among oscillometric waveforms in healthy nonpregnant women, pregnancy and hypertensive disorders of pregnancy

Jennifer S Ringrose et al. Blood Press Monit. .

Abstract

Objective: Understanding of how oscillometric waveforms (OMW) vary between pregnant and nonpregnant individuals remains low. An exploratory analysis was completed to assess for quantitative and qualitative changes in OMW and oscillometric envelope features in pregnancy.

Design and methods: Eighteen pregnant individuals (over 20 weeks gestational age) and healthy, nonpregnant (HNP) women were recruited. Six HNP were matched to six healthy pregnant (HP) women, and six pregnant women with a hypertensive disorder of pregnancy (HDP) by age, arm circumference, and cuff size. Blood pressure measurements were completed per the International Organization for Standardization (ISO) protocol using a custom-built oscillometric device as the test device and two-observer mercury auscultation as the reference measurement. Auscultatory blood pressure and blood pressure derived from slope-based and fixed ratio algorithms were determined. OMW and envelope features were compared among groups.

Results: In HNP, HP, and HDP groups respectively: mean auscultatory blood pressure (systolic mean ± SD/diastolic mean ± SD) was 103.4 ± 12.2/67.1 ± 7.9; 109.5 ± 3.1/58.1 ± 6.4; 135.6 ± 18.9/85.1 ± 14.2 mmHg. HDP had significantly higher auscultatory systolic and diastolic blood pressure than the HP group ( P = 0.001). The pregnant groups had a lower average pulse width (mean ± SD: HNP = 0.8 ± 0 s, HP = 0.6 ± 0.1 s, HDP = 0.6 ± 0.1 s; HP vs. HNP mean difference [adjusted P value]: 0.2 [ P = 0.004], HDP vs. HNP 0.1 [ P = 0.018]) compared with the HNP group. The HDP group had a larger area under the OMW envelope than the HNP group (mean ± SD: HNP = 22.6 ± 3.4; HDP = 28.5 ± 4.2; HDP vs. HNP mean difference [adjusted P value]: 5.9 P = 0.05).

Conclusion: In this exploratory work, differences in the OMW morphology and parameters were found in pregnancy and in hypertensive disorders of pregnancy compared with healthy controls. Even small differences may have important implications in algorithm development; further work comparing OMW envelopes in pregnancy is needed to optimize the algorithms used to determine blood pressure in pregnancy.

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References

    1. Magee LA, Smith GN, Bloch C, Côté A-M, Jain V, Nerenberg K, et al. Guideline no. 426: hypertensive disorders of pregnancy: diagnosis, prediction, prevention, and management. J Obstet Gynaecol Can 2022; 44:547–571.e1.
    1. Bello NA, Woolley JJ, Cleary KL, Falzon L, Alpert BS, Oparil S, et al. Accuracy of blood pressure measurement devices in pregnancy: a systematic review of validation studies. Hypertension 2018; 71:326–335.
    1. Nathan HL, Hezelgrave NL, Widmer M, Chappell LC, Shennan AH. Setting and techniques for monitoring blood pressure during pregnancy. Cochrane Database Syst Rev 2017; 2017:1–9.
    1. Rabi DM, McBrien KA, Sapir-Pichhadze R, Nakhla M, Ahmed SB, Dumanski SM, et al. Hypertension Canada’s 2020 comprehensive guidelines for the prevention, diagnosis, risk assessment, and treatment of hypertension in adults and children. Can J Cardiol 2020; 36:596–624.
    1. Whelton PK, Carey RM, Aronow WS, Casey DEJ, Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension 2018; 71:e13–e115.