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Background Since hypertensive disorders of pregnancy are common, blood pressure is frequently measured in all pregnant women. Many authorities recommend that Korotkoff phase IV (K4, muffling of sound) is taken as the diastolic identification point measured on mercury sphygomanometry in pregnancy because of reports that phase V (K5, disappearance of sound) is at or near to zero cuff pressure in some pregnant women. We compared the identification and reproducibility of K4 and K5 by observers unaware of each other's results.

Methods In the first part of the study, two pairs of observers each took 340 measurements in 85 pregnant women. The second part of the study consisted of 1120 measurements in 80 pregnant and 80 non-pregnant women by five pairs of observers. Measurements were taken simultaneously by sphygmomanometry with a shared cuff and diaphragm; the observers were in separate …