TRENDS OF VITAL SIGNS WITH GESTATIONAL AGE IN NORMAL PREGNANCIES: A SYSTEMATIC REVIEW PROTOCOL
Loerup L., Pullon R., Birks J., Fleming SG., Mackillop L., Watkinson P.
Introduction: Vital signs (blood pressure, heart rate, temperature, oxygen saturation and respiratory rate) are thought to undergo changes during and immediately after pregnancy. However, these physiological changes are not taken into account in the normal ranges, which themselves are not evidence-based, used in routine and acute care monitoring. We aim to synthesise the existing evidence base for changes in vital signs during pregnancy derive new centile charts for each stage of pregnancy and the immediate post-partum period. Methods and analysis: We will search the MEDLINE, EMBASE and CINAHL databases from their inception to April 2015 for vital signs from pregnant, intrapartum or postpartum women who were recruited as “healthy”. Assessment of bias will be conducted using a predefined set of independently agreed methodological criteria, which assigns an overall quality score to each study. Whether vital signs measurement was undertaken with measurement devices validated for use in pregnancy and in a standard posture will be recorded. We will use regression methods to construct centile charts of vital signs across pregnancy and the immediate postpartum period for each vital sign. We will compare existing reference ranges to those derived from our centile charts. Dissemination: The systematic review will be published in a peer-reviewed journal and disseminated electronically and in print. Registration reference: PROSPERO, registration number CRD42014009673