DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20180035

Self home blood pressure monitoring in pregnancy: how reliable is it?

Hemapriya L., Nagaraj Desai, Ambarish Bhandiwad

Abstract


Background: The use of automated blood pressure monitors in pregnancy has become increasingly popular, as more women tend to get involved in their healthcare. Not only does it reduce clinician visits, it also helps to eliminate the white coat hypertension.

Methods: We conducted a prospective study in the antenatal department of JSS Medical College and Hospital, Mysuru; over a period of one year, from July 2016 to June 2017. The blood pressures of 50 women were recorded at four different periods of gestation using the conventional ‘Diamond mercury Sphygmomanometer’ versus the automated ‘Omron HEM 7130’ home BP monitor and compared.

Results: The recordings of systolic blood pressure at home were consistently less than the office measurements at all periods of gestation. However, the difference was not statistically significant. The comparison of diastolic pressures revealed minimal variations between the mean of the office and home blood pressure recordings. The mean arterial pressure also revealed a similar trend.

Conclusions: Self-monitoring of blood pressure is a feasible and acceptable option to pregnant women. It might make antenatal care more effective, but we need further research to establish safety and efficacy, the impact on women and health professionals, and how best to use the results.


Keywords


Diastolic blood pressure, Home BP monitoring, Mean arterial pressure, Pregnancy, Systolic blood pressure

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References


Rey E, Pilon F, Boudreault J. Home blood pressure levels in pregnant women with chronic hypertension. Hypertens Pregn. 2007;26(4):403-14.

Pickering TG, Phil D, White WB. When and how to use self and ambulatory blood pressure monitoring. J Am Soc Hypertens. 2008;2(3)119-24.

Dehaeck U, Thurston J, Gibson P, Stephanson K, Ross S. Blood pressure measurement for hypertension in pregnancy. J Obstet Gynecol Can. 2010 Apr;32(4):328-34.

Magee LA, von Dadelszen P, Chan S, Gafni A, Gruslin A, Helewa M, et al. Women’s views of their experiences in the CHIPS (Control of Hypertension in Pregnancy Study) pilot trial. Hypertens Pregnancy. 2007;26:371-87.

National Institute for Health and Care Excellence. Antenatal care. NICE clinical guideline CG62. NICE, 2008.

Meads CA, Cnossen JS, Meher S, Juarez-Garcia A, Riet G, Duley L, et al. Methods of prediction and prevention of pre-eclampsia: systematic reviews of accuracy and effectiveness literature with economic modelling. Health Technol Assess. 2008;12.

National Institute for Health and Clinical Excellence. Hypertension in pregnancy. NICE clinical guideline CG107. NICE, 2010.

Kitagawa M, Akiyama Y, Omi H, Sago H, Natori M. Development and clinical application of a telemedicine support system in the field of perinatal patient management. J Obstet Gynaecol Res. 2000;26:427-34.

Rayburn WF, Zuspan FP, Piehl EJ. Self-monitoring of blood pressure during pregnancy. Am J Obstet Gynecol. 1984;148:159-62.

Rayburn WF, Piehl EJ, Compton AA. Clinical significance of home blood pressure monitoring during pregnancy. Clin Exp Hypertens Part B. 1985;4:63-73.

Naef RW, Perry KG Jr, Magann EF, McLaughlin BN, Chauhan SP, Morrison JC. Home blood pressure monitoring for pregnant patients with hypertension. J Perinatol. 1998;18:226-9.

Cartwright W, Dalton KJ, Swindells H, Rushant S, Mooney P. Home measurement of pregnancy hypertension. Professional Care Mother Child. 1993;3:8-9.

Cartwright W, Dalton KJ, Swindells H, Rushant S, Mooney P. Objective measurement of anxiety in hypertensive pregnant women managed in hospital and in the community. Br J Obstet Gynecol. 1992;99:182-5.

Denolle T, Weber JL, Calvez C, Getin Y, Daniel JC, Lurton O, et al. Diagnosis of white coat hypertension in pregnant women with teletransmitted home blood pressure. Hypertens Pregnancy. 2008;27:305-13.

Taylor RS, Freeman L, North RA. Evaluation of ambulatory and self-initiated blood pressure monitors by pregnant and postpartum women. Hypertens Pregnancy. 2001;20:25-33.

Reinders A, Cuckson AC, Jones CR, Poet R, O’Sullivan G, Shennan AH. Validation of the Welch Allyn ‘Vital Signs’ blood pressure measurement device in pregnancy and pre-eclampsia. BJOG. 2003;110:134-8.

Natarajan P, Shennan AH, Penny J, Halligan AW, de Swiet M, Anthony J. Comparison of auscultatory and oscillometric automated blood pressure monitors in the setting of preeclampsia. Am J Obstet Gynecol. 1999;181:1203-10.

Chung Y, de Greeff A, Shennan A. Validation and compliance of a home monitoring device in pregnancy: Microlife WatchBP Home. Hypertens Pregnancy. 2009;28:348-359.

De Greeff A, Reggiori F, Anthony J, Shennan A. The Microlife 3AC1: an accurate blood pressure measurement device in pregnancy and pre-eclampsia. J Hypertens. 2006;24(suppl 4):S279.

Reinders A, Cuckson AC, Lee JTM, Shennan AH. An accurate automated blood pressure device for use in pregnancy and pre-eclampsia: the Microlife 3BTO-A. BJOG. 2005;112:1-6.

De Greeff A, Beg Z, Gangji Z, Dorney E, Shennan AH. Accuracy of inflationary versus deflationary oscillometry in pregnancy and preeclampsia; Omron MIT versus Omron M7. Blood Pressure Monit. 2009;14:37-40.

Golara M, Benedict A, Jones C, Randhawa M, Poston L, Shennan AH. Inflationary oscillometry provides accurate measurement of blood pressure in pre-eclampsia. Br J Obstet Gynaecol. 2002;109:1143-7.

NICE. Hypertension: clinical management of primary hypertension in adults. NICE guideline CG127. 2011. Available at http://guidance.nice.org.uk/CG127.

Hermida RC, Ayala DE. Diagnosing gestational hypertension and pre-eclampsia with the 24-hour mean of blood pressure. Hypertension. 1997;30:1531-7.

Hermida RC, Ayala DE. Reference thresholds for 24-h, diurnal, and nocturnal ambulatory blood pressure mean values in pregnancy. Blood Pressure Monit. 2005;10:33-41.

Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. 2004. Available at www.nhlbi.nih.gov/guidelines/hypertension/ jnc7full.htm.

Lindheimer MD, Akbari A. Hypertension in pregnant women. In: Oparil S, Weber MA, eds. Hypertension: a companion to Brenner and Rector’s the kidney. W B Saunders;2000:688-701.

National Institutes of Health. Working group report on high blood pressure in pregnancy. National High Blood Pressure Education Program;2000.

National Collaborating Centre for Women’s and Children’s Health. Antenatal care: routine care for the healthy pregnant woman. RCOG. 2008.