This project took place at our Edinburgh centre which operated between 2008 and 2021.
Why do we need this research?
Around 1 in 10 pregnant women have chronic hypertension – high blood pressure before or early in pregnancy. Almost half of these will go on to develop pre-eclampsia, a condition that is characterised by a combination of raised blood pressure and protein in the urine. Pre-eclampsia can be dangerous for the mother and also puts the baby at risk of being born too small or too soon.
Blood pressure monitoring and urine analysis are carried out routinely at antenatal appointments to check for pre-eclampsia. However, to keep pregnant women safe during the COVID-19 pandemic, the NHS has had to reduce the amount of face-to-face contact women have with their care providers. For women at high risk of developing pre-eclampsia or who are shielding due to serious underlying medical conditions, self-monitoring of blood pressure and urine may therefore be necessary to make sure that pre-eclampsia is not missed.
What happened in this project?
Self-monitoring of blood pressure outside of pregnancy has been shown to increase convenience, empower patients, improve adherence to medication and improve blood pressure control. Despite this, home blood pressure monitoring has not been widely adopted, perhaps due to the challenges associated with implementing new models of care.
As a result of the COVID-19 pandemic, researchers at the Tommy’s Centre for Maternal and Fetal Health in Edinburgh contributed to a Scottish government initiative to roll out home blood pressure monitoring and urine analysis to high-risk and shielded pregnant women across Scotland. Uptake varied in different NHS health boards, with several barriers being identified that prevented women and their caregivers from engaging with the rollout. In general, the team found that almost all women were supportive of home monitoring.
What difference will this project make?
This project has shown that pregnant women were happy to monitor blood pressure and urine at home. In the short term, this could help shielded or high-risk pregnant women by reducing the need for face-to-face appointments during the COVID-19 pandemic. Self-monitoring might also be beneficial in the longer term, particularly for women in more rural and remote locations who have to travel long distances to attend antenatal appointments.
