Blood pressure - Harvard

Doctor recommended Blood pressure Monitor

  • Use a sitting or semi-reclining position so that the arm to be used is at the level of the heart.
  • Do not take the BP in the upper arm with the woman on her side, as this will give falsely lower readings.
  • Korotkoff phase 5 measurements should be used for taking the diastolic pressure, except on those rare instances when sounds continue to be heard to 0 mm Hg when Korotkoff phase 4 can be used.

Management

Management depends on the woman's BP, gestational age and blood flow in the placenta. Non-pharmacological management is recommended for many women but is not recommended when there is the presence of associated maternal and fetal risk factors. Non-pharmacological management includes close supervision, limitation of activities, and some bed rest in the left lateral position.

All pregnant women should receive antenatal education so that they are aware of the symptoms associated with pre-eclampsia, its importance, and the need to obtain medical advice.

Such symptoms include:

  • Severe headache.
  • Visual problems: blurred vision or flashing before the eyes.
  • Severe epigastric pain.
  • Vomiting.
  • Sudden swelling of the face, hands or feet.
Women who are at high risk of pre-eclampsia are recommended to take 75 mg aspirin daily from 12 weeks of gestation to delivery. Such women are those with:
  • Hypertension or pre-eclampsia/eclampsia in a past pregnancy.
  • Chronic kidney disease.
  • Autoimmune disease (eg, systemic lupus erythematosus (SLE) or antiphospholipid syndrome).
  • Diabetes mellitus (both type 1 or 2).
  • Chronic hypertension.
Women should also take 75 mg aspirin daily from the 12th week if they have any two of the following features:
  • In their first pregnancy.
  • Aged ≥40 years.
  • Previous pregnancy >10 years ago.
  • Body mass index (BMI) of ≥35 kg/m2 at booking.
  • Family history of pre-eclampsia.
  • Multiple pregnancy.
Source: patient.info
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