Regarding the BP measurement technique, the last
WHO publication is from 2005. Diastolic BP measurement
is the most reliable indicator for the diagnosis of hypertensive
disorders in pregnancy, since it is assessed through
its measurement, peripheral vascular resistance and the obtained
value does not vary with maternal emotional state.
Therefore, the recommendations are: measurement of DBP
in the fifth phase of Korotkoff; clamp cover at least three
quarters of the circumference of the forearm and right arm;
performing at least two measurements at intervals longer
than six hours between measurements(6).
Noteworthy that in a study on the current state of the
art, looking as references the guidelines of the WHO, the
American College of Obstetricians and Gynaecologists
(ACOG), RCOG and publications from the journal The
Lancet, it was determined that the measurement should
be always carried out with the patient sitting and arm at
heart level; the cuff should present appropriate dimensions;
DBP should be measured in the fifth Korotkoff
phase and, in any situation, manual sphygmomanometer
with mercury column should be used, since it found an
underestimation of 5-15 mmHg in both SBP and DBP
when the measurement was made with automatic measurement
apparatus(32).