Optimizing Blood Pressure Measurement for Pregnancy Care
Accurate blood pressure assessment is crucial for predicting pre-eclampsia and placental dysfunction. The Tommy's app offers a standardized approach, including proper technique, validated monitors, cuff positioning, and multiple parameters like mean arterial pressure (MAP) calculation. It emphasizes factors such as ensuring comfort, abstaining from stimulants, and using correct cuff sizes for reliable measurements. By following these guidelines, healthcare providers can enhance the quality of care for pregnant individuals.
- Pregnancy care
- Blood pressure measurement
- Pre-eclampsia risk
- Standardized approach
- Healthcare guidelines
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Presentation Transcript
Standardised Blood Pressure Measurement
Background Background Accurate blood pressure (BP) assessment is required for the prediction of pre-eclampsia and other disorders of placental function Mean arterial pressure (MAP) is one of multiple parameters used in the Tommy s app to calculate the risk of placental dysfunction The tool will automatically calculate the MAP when a user enters the diastolic and systolic measurements
Technique Technique Sit down for 5 minutes: Ensure women are seated comfortably with 2 feet flat on the ground for 5 minutes prior to BP measurement. (Crossing of legs may increase BP) No smoking or caffeine for 30 minutes: Women should refrain from smoking or consuming caffeine at least 30minutes prior to BP measurement. (Smoking and caffeine may increase BP) Measure Arm Circumference: Measure the mid upper arm circumference using a tape measure. Match the appropriate cuff size to the arm circumference. (If cuff too large - BP overestimated, if cuff too small - BP underestimated) Use a validated blood pressure monitor: Ensure the blood pressure monitor has been calibrated and is validated for use in pregnancy and pre-eclampsia (see slide 4). (Non-validated BP monitors can significantly underestimate BP in pregnancy)
Validated Monitors: Validated Monitors: for use in pregnancy and pre- eclampsia 1. Omron M7 9. Microlife Watch BP Home A BT 2. Omron MIT 10. Microlife Watch BP Home S 3. Omron MIT Elite 11. Microlife Cradle VSA 4. Omron HEM-9210T 12. Andon, iHealth Track 5. Omron BP760N 13. Dinamap ProCare 400 6. Microlife Watch BP Home A 14. A&D UM-101 7. Microlife BP 3BTO-A 15. Nissei DS-400 8. Mircorlife BP 3AS1-2 16. Omron HEM907 Hurrell, et al (2021)
Cuff Position Cuff Position The BP cuff should be positioned 2cms (two finger breadths) above the crease in arm This correct positioning ensures the cuff is in line with the woman s heart. If cuff positioned above the heart, the MAP is underestimated. If cuff positioned below the heart, the MAP is overestimated.
Blood Pressure Measurement Blood Pressure Measurement 1. Sit with 2 feet flat on the ground 2. Using correct cuff size Brachial Artery 3. Position cuff 2cms above crease of arm, with the artery mark in line with the brachial artery Artery Mark 4. Take four BP measurements (20-30 second intervals) 5. Use the 4thBP reading for the Tommy s clinical decision tool Systolic Diastolic 6. Input the systolic and diastolic measurements and the tool will automatically calculate the MAP
Recording Blood Pressure Recording Blood Pressure 1. Click Placental Function Assessment 2. Click Run Placental Function Assessment 3. Enter Systolic and Diastolic readings
Further Information and Resources Further Information and Resources References 1. Hurrell et al (2021) The assessment of blood pressure in pregnant women: pitfalls and novel approaches, AJOG. 2. https://www.fetalmedicine.org/education/preeclampsia-screening For further information: www.rcog.org.uk/tommys www.
