Home blood‐pressure monitoring in a hypertensive pregnant population: cost‐minimization study

Xydopoulos, Georgios; Perry, Helen; Sheehan, Elaine; Thilaganathan, B.; Fordham, Richard; Khalil, Asma

doi:10.1002/uog.19041

Cited by 45 publications

(55 citation statements)

References 22 publications

(28 reference statements)

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“…These women are likely to benefit from closer blood pressure monitoring that can be performed by using different approaches and tools. For instance, the introduction of telemonitoring system in pregnancies has made the blood pressure monitoring more accessible and cost-saving [ 35 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

Are Twin Pregnancies Complicated by Weight Discordance or Fetal Growth Restriction at Higher Risk of Preeclampsia?

Giorgione

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et al. 2020

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Studies have reported controversial findings on the association between fetal growth restriction (FGR) or intertwin weight discordance and the risk of hypertensive disorders of pregnancy (HDP) in twin pregnancies. The aim of this study was to investigate the association between twin growth disorders and HDP. Twin pregnancies resulting in two live births at St George’s Hospital between 2000 and 2019 were included. FGR or small-for-gestational-age (SGA) at birth was assessed using singleton and twin reference charts. Intertwin discordance [(large birthweight − small birthweight)/(large birthweight) × 100%)] was calculated. Logistic regression models were performed. SGA (aOR 2.34, 95% CI 1.60–3.44, p < 0.001), intertwin discordance ≥25% (aOR 2.10, 95% CI 1.26–3.49, p = 0.004) and their co-existence (aOR 2.03, 95% CI 1.16–3.54, p = 0.013) were significantly associated with HDP. After adjusting for the known maternal risk factors of HDP and the intertwin discordance, SGA (using the twin charts) was the strongest independent risk factor associated with HDP (aOR 2.12, 95% CI 1.40–3.22, p < 0.001) and preeclampsia (aOR 2.34, 95% CI 1.45–3.76, p < 0.001). This study highlights that the presence of at least one SGA twin is significantly associated with HDP during pregnancy. Therefore, maternal blood pressure should be closely monitored in twin pregnancies complicated by SGA with or without intertwin discordance.

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Section: Discussionmentioning

confidence: 99%

Are Twin Pregnancies Complicated by Weight Discordance or Fetal Growth Restriction at Higher Risk of Preeclampsia?

Giorgione

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Bhate

et al. 2020

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“…Our recent work has demonstrated that HBPM reduces the number of hospital visits without compromising maternal and fetal outcomes. Furthermore, HBPM was found to be cost‐effective, with an average saving per week of £286.53 in the group of women following HBPM using a dedicated app, compared with those undergoing traditional monitoring at the hospital/clinic. Despite these potential benefits, only a limited number of studies have compared blood‐pressure values recorded at home with those recorded at the clinic, with conflicting results reported.…”

Section: Introductionmentioning

confidence: 99%

Is home blood‐pressure monitoring in hypertensive disorders of pregnancy consistent with clinic recordings?

Kalafat

Mir

Thilaganathan

et al. 2018

Ultrasound in Obstet & Gyne

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Our study shows that, in women with HDP, blood pressure measured at home is lower than that measured in a clinic setting. This is consistent with observations in non-pregnant adults, in whom home and ambulatory monitoring of hypertensive patients is recommended. As such, HBPM has the potential to reduce the number of false-positive diagnoses of severe hypertension and unnecessary medical interventions in women with HDP. This must be carefully weighed against the risk of missing true-positive diagnoses. Prospective studies investigating the use of HBPM in pregnant women are urgently needed to determine the relevant blood-pressure thresholds for HBPM, and interval and frequency of monitoring. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.

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“…Second, UK government agencies have procured and validated BP monitors for purchase by hospitals, for domiciliary use by hypertensive pregnant women. Third, use of BP apps is being encouraged to facilitate recording of BP and transmission of BP values to care providers; K2 Hampton (https://www.k2ms.com) is the only pregnancy BP app certified as a Class-I medical device in the UK and extensively evaluated within the NHS [5][6][7] .…”

Section: Measure Bp With Device Validated For Use In Pregnancymentioning

confidence: 99%

“…The implications on pregnancy outcomes and costs of a reliance on HBPM to replace many clinic measurements are unknown. Preliminary evidence in hypertensive women attending for specialist care suggests that use of HBPM and a BP app may reduce outpatient healthcare utilization (even among women with recently diagnosed gestational hypertension 5 ) and costs 7 .…”

Section: Measure Bp With Device Validated For Use In Pregnancymentioning

confidence: 99%

Pregnancy hypertension diagnosis and care in COVID‐19 era and beyond

Magee

Khalil

Dadelszen

2020

Ultrasound in Obstet & Gyne

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Home blood‐pressure monitoring in a hypertensive pregnant population: cost‐minimization study

Abstract: 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.

Cited by 45 publications

References 22 publications

Are Twin Pregnancies Complicated by Weight Discordance or Fetal Growth Restriction at Higher Risk of Preeclampsia?

Are Twin Pregnancies Complicated by Weight Discordance or Fetal Growth Restriction at Higher Risk of Preeclampsia?

Is home blood‐pressure monitoring in hypertensive disorders of pregnancy consistent with clinic recordings?

Pregnancy hypertension diagnosis and care in COVID‐19 era and beyond

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