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Plea for pregnancy care blood tests

Plea for pregnancy care blood tests
Photo: Plea for pregnancy care blood tests
Checking the blood pressure of pregnant women accurately and regularly is the best way of diagnosing potentially deadly hypertensive disorders, according to research.

Hypertension (high blood pressure) is the most common medical problem in pregnancy, affecting up to 15 per cent of pregnancies and accounting for about a quarter of all antenatal admissions in the UK.

Hypertensive disorders carry significant risks to maternal health and remain one of the leading causes of maternal mortality worldwide, while they also carry risks for the baby and can result in death or low pre-term or birth weight.

The review published in The Obstetrician & Gynaecologist (TOG) said accurate blood pressure measurement is also important for the diagnosis and management of other issues such as obstetric haemorrhage, sepsis and safe abortion.
It said blood pressure monitoring is the most important and frequent screening test in the antenatal period and should be undertaken by healthcare assistants, midwives, general practitioners and obstetricians on all pregnant women regularly.

The paper highlighted a previous report which found that the most common reason for substandard care in maternal deaths in the UK, secondary to pre-eclampsia/eclampsia, was failure to recognise and treat hypertension.

There were 321 maternal deaths from direct or indirect causes in the UK in 2009-12 but death rates from hypertensive disorders of pregnancy are lower than ever.

Nearly all (99 per cent) of maternal deaths occur in low and middle income countries, where contributing factors include a lack of access to cheap, easy to use blood pressure monitoring devices.

TOG editor-in-chief Jason Waugh said the review showed the ability to measure blood pressure accurately is an indispensable skill for all healthcare workers, regardless of setting, in preventing maternal and perinatal morbidity and mortality worldwide.

"This review is helpful in enabling clinicians to do everything they can to ensure that their BP measurement is accurate," Waugh said.

Co-author and professor of obstetrics at the Women's Health Academic Centre at King's College London, Andrew Shennan, says there are several things clinicians can do to increase the accuracy of their BP measurement.

This includes becoming more aware of the advantages and disadvantages of the various available devices, having the confidence to raise concerns regarding any devices that are inaccurate for use in pregnancy and correcting any poor techniques they have observed, he said.

TOG is the quarterly medical journal of the Royal College of Obstetricians and Gynaecologists' (RCOG).

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