by 5thtymachrm (909 Posts), Thu Aug 05, 2004 08:19 pm
I know that in the medical practice i worked in , we considered any BP device that was on the wrist to be incorrect, as much as 15 points off what you really are. I would call and ask your peri what they think of it.
This info is provided from pluspregnancy.org in their bp cuff sizing information:
"Blood Pressure Readings on the Forearm
If there is no large blood pressure cuff available, or if the circumference of a person's arm exceeds the guidelines of the largest blood pressure cuff available, it is possible to take a blood pressure reading on a person's forearm (Singer, 1999). This technique is sometimes used on people who are extremely large in an emergency when there is no thigh cuff available or if the thigh cuff is too small for the person's arm. (Many thigh cuffs are accurate only to about 20 inches.)
However, the validity of forearm blood pressure measurement is questionable. Providers must be cautious about relying on forearm measurements, as the results may not be accurate. For example, the journal American Family Physician, writing in its article, "Medical Care for Obese Patients: Advice for Health Care Professionals," states:
If the upper arm circumference exceeds 50 cm [19.6 inches], the American Heart Association recommendations suggest using a cuff on the forearm and feeling for the appearance of the radial pulse at the wrist to estimate systolic blood pressure. The recommendations note that the accuracy of forearm measurement has not been validated.
Graves (2001) notes that while forearm blood pressure readings are possible, "These readings are not usually performed as falsely higher diastolic blood pressure readings may be obtained." Singer (1999) found that readings were within 20 mm Hg in the majority of people, which is not that significant in an emergency situation with non-pregnant people. However, a difference of 20 points can make a lot of difference in treatment decisions in pregnancy.
If a blood pressure is truly needed (like in an emergency situation) and there are no other options, a forearm measurement can offer an approximate idea of what a person's blood pressure is likely to be. Since many extremely obese people have blood pressure issues and this can lead to significant health problems, forearm BPs remain an option if no other choice exists. Better to have some idea of a person's blood pressure than none at all.
However, forearm readings are not an adequate substitute for proper equipment under normal circumstances. There are other options that should be pursued instead whenever possible. For example, some "thigh" cuffs are available now that are accurate for arm sizes above 20 inches. In addition, as noted above, www.amplestuff.com sells blood pressure cuffs that are accurate for extremely large arms, up to 35 inches in circumference. So there are better alternatives available than forearm blood pressure readings.
If your arm is significantly larger than 16-17 inches or so, you may want to purchase your own blood pressure cuff so that you do not have to worry whether your provider has a large enough cuff. If your arm size is over 20 inches, you should definitely consider buying your own properly-sized cuff because your provider is unlikely to carry a cuff appropriate for your arm.
Because forearm blood pressure readings are not validated to be accurate and because high blood pressure in pregnancy leads to so many interventions, forearm blood pressure readings should not be used in pregnancy except in unusual emergency situations where no other options are available. Otherwise, the proper sized cuff should be purchased and used consistently.
Either work with your provider to have them purchase the proper cuff for you, or you buy the cuff for them with the understanding that you will receive a partial discount on your prenatal bills. However, the best choice of all may be to buy your own and take it with you to every appointment and to the hospital."
Indigo E. 11/20/03 csec,PE,IUGR,chronic HBP,hypothyroid,asthma,hyperemesis,33wks on BR.
4 prev. m/c's
ttc #2 is a go!