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 consider reducing 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 analysis may therefore be important to make sure that pre-eclampsia is not missed.
What’s happening 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.
Now, researchers at the Tommy’s Centre for Maternal and Fetal Health in Edinburgh are contributing to a Scottish government initiative to find out whether the rapid rollout of home blood pressure monitoring to high-risk and shielded pregnant women across Scotland is effective, and whether it is acceptable to women and their caregivers. The team will be monitoring uptake and adherence to home monitoring to see if there are any unexpected barriers that might prevent women and their caregivers from engaging with the rollout. They will also assess the clinical and economic impact of home blood pressure monitoring in pregnancy.
What difference will this project make?
This project will find out whether it is acceptable and effective for pregnant women to monitor blood pressure 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 of blood pressure 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.
