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Biomedical subjects

A Franx

Publications and source records attributed to A Franx.

23 records · Page 2Linked to original sources
PubMed1998

The fourth sound of Korotkoff in pregnancy: a myth.

OBJECTIVE: To determine the detection rate and the reproducibility of the first (K1), the fourth (K4) and the fifth (K5) phases of the Korotkoff sounds in pregnant women. STUDY DESIGN: In 77 pregnant women receiving antenatal care in a tertiary referral centre, two observers took 231 simultaneous blood pressure measurements with a shared mercury sphygmomanometer and a multi-aural stethoscope. Detection rates, percentages of observer agreement within 5 mmHg and kappa values were calculated for K1, K4 and K5. RESULTS: Both observers were able to detect K1, K4 and K5 in 98, 24 and 98% of all 231 measurements, respectively. In 46% of measurements, and in 23% of women, neither observer was able to detect K4. The observers agreed within 5 mmHg in 98 (kappa = 0.99), 69 (kappa = 0.42), and 96% (kappa = 0.99) of measurements for K1, K4 and K5, respectively. CONCLUSION: K4 cannot be detected and reproduced accurately in a significant proportion of pregnant women, and therefore should be abandoned as diastolic endpoint in pregnancy.

Auscultation↗
PubMed1998

Within-subject variability of differences between conventional and automated blood pressure measurements in pregnancy.

OBJECTIVE: To determine whether measured differences between standard mercury sphygmomanometry and the SpaceLabs 90207 ambulatory blood pressure monitor in pregnant women remain constant during 24 h measurements. STUDY DESIGN: Repeated comparisons between standard mercury sphygmomanometry and Spacelabs 90207 were performed at nine predetermined time points during 24 h ambulatory blood pressure measurements in a group of ten pregnant women with various pregnancy complications, including hypertension. Individual and group differences between standard mercury sphygmomanometry and SpaceLabs 90207 were calculated for each time point. Friedman's ANOVA was used to test stability of differences across time. RESULTS: Mean group differences (standard deviation) between mercury sphygmomanometry and the SpaceLabs 90207 were -2 (6) mmHg and 3 (7) mmHg for systolic and diastolic pressure respectively. For systolic pressure the differences between time points were not statistically significant. Although a statistical significant trend was found for diastolic pressure differences (P<0.05), none of the contrasts between any pair of time points reached statistical significance. For both systolic and diastolic pressure the minimal and maximal difference lay at least 10 mmHg apart in seven patients. CONCLUSIONS: Despite standardisation and training, a substantial within-subject variability of the pressure difference between observers and SpaceLabs was found in this heterogeneous group of women. However, a systematic time-related effect on this pressure difference could not be demonstrated. The pressure difference between both methods cannot be estimated with great precision. This is a serious impediment for the clinical interpretation of automated or ambulatory blood pressure data.

Adult↗