Accuracy of Blood Pressure Measurement Devices in Pregnancy: A Systematic Review of Validation Studies

摘要

The accurate measurement of blood pressure in pregnancy is essential to guide medical decision making that affects both mother and fetus. The aim of this systematic review was to determine the accuracy of ambulatory, home, and clinic blood pressure measurement devices in pregnant women. We searched Ovid MEDLINE, The Cochrane Library, EMBASE, CINAHL EBSCO, Clinicaltrials.gov, International Clinical Trials Registry Platform, and dabl from inception through August 3, 2017 for articles that assessed the validity of an upper arm blood pressure measurement device against a mercury sphygmomanometer in pregnant women. Two independent investigators determined eligibility, extracted data, and adjudicated protocol violations. From 1,798 potential articles identified, 41, that assessed 28 devices, met the inclusion criteria. Most articles (N= 32) followed a standard or modified American National Standards Institute/Association for the Advancement of Medical Instrumentation/International Organization for Standardization, British Hypertension Society, or European Society of Hypertension validation protocol. Several articles described the results of validation studies performed on more than one device (N=7) and/or in more than one population of pregnant women (N=12), comprising 64 pairwise validity assessments. The device was validated in 61% (32 of 52) of studies which used a standard or modified protocol. Only 34% (11 of 32) of the studies wherein the device was successfully validated were performed without a protocol violation. Given the implications of inaccurate blood pressure measurement in pregnant women, healthcare providers should be aware of and try to use the blood pressure measurement devices which have been properly validated in this population.