Objective

HBPM in hypertensive pregnancies appears to be cost-saving compared with traditional monitoring, without compromising maternal, fetal or neonatal safety. Larger studies are required to confirm these findings.

To explore in depth, the experiences of pregnant women with a history of hypertension using an innovative home blood pressure service to monitor for signs of pre-eclampsia and/or worsening blood pressure. Objectives 1. To assess participants' acceptability of home blood pressure monitoring and a reduced hospital appointment schedule. 2. To explore patient satisfaction and examine the impact a new service has on women. Design A qualitative study using a grounded theory approach was undertaken. Data was collected through semi-structured interviews. Data collection and data analysis was completed simultaneously using theoretical sampling and the constant comparison method. Intervention Women who had a diagnosed hypertensive disorder of pregnancy were given a blood pressure machine to take home and monitor their blood pressure daily. They inserted their blood pressure results on a downloadable smart phone application and answered trigger questions for signs of pre-eclampsia. Participants were followed up every 2 weeks in an antenatal hypertension clinic. Findings The findings produced a substantive theory that women are in pursuit of a holistic care pathway for the management of hypertension in pregnancy. A core category and three subcategories were identified. The core category was holistic care and the subcategories were; (1) empowerment, (2) comparison of care pathways and (3) continuity of care. Key conclusions The traditional management of hypertension in pregnancy is not a holistic approach. The innovative home blood pressure service is accepted by women and incorporates elements of holistic care but more improvement is required to meet the standard of holistic care that women desire.

In order to investigate further the relationship between maternal diabetes and fetal malformation, rat embryos were grown in vitro in the presence of beta-hydroxybutyrate, one of the ketone bodies produced by diabetics. At 10 mM, beta-hydroxybutyrate produced minor abnormalities and at 20 mM it produced major abnormalities in rat embryos.