Comparison of an Auscultatory Versus an Oscillometric Ambulatory Blood Pressure Monitor in Normotensive, Hypertensive, and Preeclamptic Pregnancy

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Abstract
Objective: To compare the accuracy of the auscultatory Profilomat ambulatory blood pressure monitor and the oscillometric SpaceLabs 90207 in pregnant women. Methods: Evaluation of study devices was performed according to the device validation protocol of the British Hypertension Society. Both study devices were compared with standard mercury sphygmomanometry in one single group of 55 pregnant women, of whom 21 were normotensive, 22 had mild hypertension, and 12 mild preeclampsia. Results: The mean differences (SD) between observers and SpaceLabs 90207 were -3(6) mmHg for systolic pressure, 13(7) mmHg for Korotkoff phase 4 diastolic pressure and 4(7) mmHg for Korotkoff phase 5 diastolic pressure. The mean differences (SD) between observers and Profilomat were 3(4) mmHg for systolic pressure, 10(6) mmHg for phase 4 diastolic pressure, and 4(7) mmHg for phase 5 diastolic pressure. Both devices achieved BHS grades B, D, and C for systolic, phase 4 diastolic, and phase 5 diastolic pressures, respectively. However, 95% limits of agreement between observers and study device were wide for both SpaceLabs 90207 and Profilomat. Phase 5 diastolic pressure differences between observers and both study devices were significantly greater in hypertensive women compared to normotensive women. Conclusions: The auscultatory Profilomat monitor is as accurate as the oscillometric SpaceLabs 90207 in normotensive pregnant women, and in pregnant women with mild hypertension or mild preeclampsia. Our results do not allow conclusions on accuracy in women with severe hypertension or severe preeclampsia. For both devices, differences from mercury sphygmomanometry can be large in individual pregnant women, and increase with level of blood pressure.