HOME BLOOD PRESSURE MEASUREMENT WITH TELETRANSMISSION FOR MONITORING HYPERTENSIVE PREGNANT WOMEN

Objective: The occurrence of hypertension during pregnancy is a major cause of morbidity and mortality during pregnancy. It is therefore essential to diagnose hypertension with certainty in order to allow appropriate management, to monitor its evolution and adapt anti-hypertensive treatment if necessary. Objective: To study the feasibility and acceptability of home blood pressure measurement with teletransmission (HBPMT) for long-term follow-up of hypertensive pregnant women. The main criterion is the % of measurements initially planned and finally carried out. Design and method: Prospective multicentric pilot study (4 maternity units) conducted during 12 months in 50 pregnant women with non-severe hypertension confirmed by HBPM or on antihypertensive treatment. After training, a connected HBPMT device is given to the patient for BP monitoring throughout the pregnancy: 3 measurements in morning and evening each day. The measurement history is accessible via an application. In addition to the standard follow-up visits, an additional consultation may be initiated by the HBPMT. A satisfaction questionnaire will be completed after delivery. Results: 45/ 50 women (90%) had HBPMT monitoring for 100 days (16 to 201 days): 35 years old, 135/83 mmHg at baseline, from 23 GA (16-36) multiparous 54%, 96% on antihypertensive therapy, 53% with a history of gestational hypertension, 26% of preeclampsia. Birth at 38 GA (25 to 42) with birth weight 2864 g (580 to 4200 g). 28% of the planned measurements performed: 1.7 measurements/d, 4.9 days/ week with at least one measurement, 70% days with at least 1 measurement. 18% had a measure/d and 27% at least 5d/W. No better weekday. 46% before noon. 44% had a consultation (40%) triggered by HBPMT or hospitalization (18%: 6/ 12 delivered within 48 hours). 85% of women were satisfied or very satisfied with this monitoring and 68% of professionals and only 4% very dissatisfied 9 patients had technical problems resulting in a temporary interruption. Conclusions: This pilot study demonstrated the feasibility and acceptability of HBPMT by patients and the few dissatisfied caregivers, and its interest in monitoring these pregnant women at risk. A lighter protocol may be proposed.