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  • V. Eley
    Affiliations
    Department of Anaesthesia and Perioperative Medicine, The Royal Brisbane and Women’s Hospital and The University of Queensland, Faculty of Medicine, Brisbane, Queensland, Australia
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  • R. Christensen
    Affiliations
    Department of Anaesthesia and Perioperative Medicine, The Royal Brisbane and Women’s Hospital and The University of Queensland, Faculty of Medicine, Brisbane, Queensland, Australia
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  • S. Kumar
    Affiliations
    Mater Research Institute and Department of Maternal Fetal Medicine, The Mater Mothers’ Hospital, Brisbane, Queensland, Australia
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  • L. Callaway
    Affiliations
    The University of Queensland, Faculty of Medicine and Department of Obstetrics and Gynaecology and Obstetric Medicine, The Royal Brisbane and Women’s Hospital, Brisbane, Queensland, Australia
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Published:November 17, 2018DOI:https://doi.org/10.1016/j.ijoa.2018.11.003
      We thank you for your interest in our article.
      • Eley V.
      • Christensen R.
      • Kumar S.
      • Callaway L.
      A review of blood pressure measurement in obese pregnant women.
      We agree that the ability to accurately measure blood pressure in low-, medium- and high-resource settings is crucial. It is also important to be able to measure both low and high blood pressure accurately. On page 67 of the published manuscript
      • Eley V.
      • Christensen R.
      • Kumar S.
      • Callaway L.
      A review of blood pressure measurement in obese pregnant women.
      we state that “…five of 14 of the devices intended for clinic use (as opposed to home blood pressure monitoring use) were validated according to approved protocols and were without protocol violations.” This is a citation of the 2018 paper by Bello et al.
      • Bello N.A.
      • Woolley J.J.
      • Cleary K.L.
      • et al.
      Accuracy of blood pressure measurement devices in pregnancy.
      which was published in the journal Hypertension.
      Consistent with our citation, Bello et al.
      • Bello N.A.
      • Woolley J.J.
      • Cleary K.L.
      • et al.
      Accuracy of blood pressure measurement devices in pregnancy.
      concluded that the validation process applied in the manuscripts published by Nathan et al.
      • Nathan L.H.
      • De Greeff L.A.
      • Hezelgrave C.N.
      • Chappell H.L.
      • Shennan H.A.
      An accurate semiautomated oscillometric blood pressure device for use in pregnancy (including pre-eclampsia) in a low-income and middle-income country population: the Microlife 3AS1-2.
      • Nathan L.H.
      • De Greeff L.A.
      • Hezelgrave C.N.
      • Chappell H.L.
      • Shennan H.A.
      Accuracy validation of the Microlife 3AS1-2 blood pressure device in a pregnant population with low blood pressure.
      contained minor protocol violations, which they define in their online supplementary materials. For these studies, they attributed the minor protocol violations to the systolic and diastolic blood pressure ranges.
      The purpose of describing the findings of Bello et al.
      • Bello N.A.
      • Woolley J.J.
      • Cleary K.L.
      • et al.
      Accuracy of blood pressure measurement devices in pregnancy.
      in our manuscript was to highlight the difficulties faced in validating blood pressure measurement devices in pregnant women, even before the issues of obesity and very large arm circumference are considered. We did not intend to list all the devices evaluated by Bello et al.
      • Bello N.A.
      • Woolley J.J.
      • Cleary K.L.
      • et al.
      Accuracy of blood pressure measurement devices in pregnancy.
      As the title suggests, our manuscript is a review of blood pressure measurement in obese pregnant women. The Microlife 3AS1-2™ was validated in women with an arm circumference of up to 36 cm (in women with low blood pressure
      • Nathan L.H.
      • De Greeff L.A.
      • Hezelgrave C.N.
      • Chappell H.L.
      • Shennan H.A.
      Accuracy validation of the Microlife 3AS1-2 blood pressure device in a pregnant population with low blood pressure.
      ) and in women with a mean arm circumference of 31 cm (including women with preeclampsia, no range or standard deviation published). It is therefore reasonable that this device was not a focus of our review.

      References

        • Eley V.
        • Christensen R.
        • Kumar S.
        • Callaway L.
        A review of blood pressure measurement in obese pregnant women.
        Int J Obstet Anesth. 2018; 35: 64-74
        • Bello N.A.
        • Woolley J.J.
        • Cleary K.L.
        • et al.
        Accuracy of blood pressure measurement devices in pregnancy.
        Hypertension. 2018; 71: 326
        • Nathan L.H.
        • De Greeff L.A.
        • Hezelgrave C.N.
        • Chappell H.L.
        • Shennan H.A.
        An accurate semiautomated oscillometric blood pressure device for use in pregnancy (including pre-eclampsia) in a low-income and middle-income country population: the Microlife 3AS1-2.
        Blood Press Monit. 2015; 20: 52-55
        • Nathan L.H.
        • De Greeff L.A.
        • Hezelgrave C.N.
        • Chappell H.L.
        • Shennan H.A.
        Accuracy validation of the Microlife 3AS1-2 blood pressure device in a pregnant population with low blood pressure.
        Blood Press Monit. 2015; 20: 299-302