| Which Korotkoff sound should be used for the diastolic blood pressure in pregnancy? | |
| | |
MedLine Citation:
|
PMID: 9653859 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
There is a gathering momentum favouring the adoption of the 5th Korotkoff sound to identify diastolic blood pressure in pregnancy. Our objective was to measure interobserver reliability for indirect blood pressure measurement in pregnancy for systolic and diastolic measurements and to calculate the difference in diastolic pressure measured by the 4th and 5th Korotkoff sounds. To minimize bias we used trained but previously inexperienced observers with proven, normal auditory acuity. The observers were paired in 4 teams and performed a series of 334 blinded, simultaneous observations of systolic and diastolic blood pressure measurements taken from pregnant women between 12-41 weeks' gestation. Reliability was measured by intraclass correlation coefficient for paired measures and kappa for the detection or nondetection of 4th (K4) and 5th (K5) Korotkoff sounds. K4 was undetected in 36% of observations and K5 was undetected in 2% of observations. Reliability for detection or nondetection of Korotkoff sounds was fair for K4 (kappa 0.36) and moderate for K5 (kappa 0.58). Reliability was good between observers for systolic, K4 and K5 diastolic measurements (intraclass correlation > or = 0.80). The mean difference between the diastolic pressure measured by K4 and K5 was 15 mmHg for all measurements and 8 mmHg for the top quartile of measurements (p <0.001). We found K5 to be more often and more reliably detected than K4. If units adopt K5 in preference to K4, consideration will need to be given to lowering treatment thresholds for women with borderline or mild hypertension. |
| | |
Authors:
|
P M Duggan |
Related Documents
:
|
20058989 - Unsteady laryngeal airflow simulations of the intra-glottal vortical structures. 7148649 - Frequency analysis approach to the origin of the first and second heart sounds. 1103909 - Clinical experience with use of ultrasound sphygmomanometer. 18350369 - Factors that affect pulse wave time transmission in the monitoring of cardiovascular sy... 17102229 - Early detection of pulmonary hypertension with heart sounds analysis pilot study. 6505049 - Novel long-term cardiovascular effects of industrial noise. 3326679 - Comparative efficacy and safety of immediate-release and controlled-release hydralazine... 22402909 - Comparison of overlapping (op) and adjacent thumb positions (ap) for cardiac compressio... 522189 - Biofeedback and relaxation in blacks with hypertension: a preliminary study. |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: The Australian & New Zealand journal of obstetrics & gynaecology Volume: 38 ISSN: 0004-8666 ISO Abbreviation: Aust N Z J Obstet Gynaecol Publication Date: 1998 May |
Date Detail:
|
Created Date: 1998-09-28 Completed Date: 1998-09-28 Revised Date: 2009-11-11 |
Medline Journal Info:
|
Nlm Unique ID: 0001027 Medline TA: Aust N Z J Obstet Gynaecol Country: AUSTRALIA |
Other Details:
|
Languages: eng Pagination: 194-7 Citation Subset: IM |
Affiliation:
|
The University of Adeliaide, Department of Obstetrics and Gynaecology, The Lyell McEwin Health Service, South Australia. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Blood Pressure Determination* Diastole / physiology* Female Humans Infant, Newborn Observer Variation Pregnancy / physiology* Pregnancy Trimesters Reference Values Sensitivity and Specificity Sound Systole / physiology |
| Comments/Corrections | |
Comment In:
|
Aust N Z J Obstet Gynaecol. 1998 Nov;38(4):479-80
[PMID:
9890244
]
Aust N Z J Obstet Gynaecol. 1998 Nov;38(4):480-1 [PMID: 9890245 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Study of cervicovaginal fetal fibronectin status to guide treatment of threatened preterm labour.
Next Document: Blood pressure measurement in pregnancy--a survey of methods used in teaching hospitals in South Aus...