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Case of Elevated Blood Pressure During Pregnancy
I recently saw a 20 year old, 32 weeks primigravida whose blood pressure was elevated at 140/100 mmHg. However, blood pressure in her bedside chart was recorded normal at 124/76 and she was not labelled as hypertensive. She did have about 2.7 g/day of total protein excretion. When, I checked her blood pressure in supine position it was 140/100. Then, nurse checked her BP in recumbent (right lateral in upper arm) and her BP was normal at 130/88 mmHg. In sitting position her BP was 138/94 mmHg. I was told that the practice is to check all pregnant patient's BP in recumbent position. Questions: 1. What is the proper way to check Blood Pressure of a Pregnant woman? As a general rule, I have always measured pt's BP while they are in the sitting position. I was taught that in the supine position there may be compression on the IVC causing transient hypotension. On the other hand, Nancy usually measures BP in the Lt lateral decubitus position if BP is elevated in the sitting position.
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