{"title":"Self antenatal monitoring of blood pressure at home as interVention ( SAMBHAV) in hypertensive women: Challenges in the developing country","authors":"Bhawana Meena, Manju Puri, Reena Yadav, Manisha Kumar","doi":"10.1016/j.preghy.2025.101201","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>To find the feasibility of home BP monitoring (HBPM) in hypertensive disorders of pregnancy (HDP) in a developing country setting.</div></div><div><h3>Methods</h3><div>In this randomized control trial 170 women with HDP between 32–36 week gestation were recruited. HBPM was done in cases and controls underwent biweekly blood pressure (BP) monitoring by clinician, randomization was done by computer-generated numbers in 1:1 ratio. The BP levels, frequency of antenatal visits, duration of hospital stay and delivery outcome of cases and controls were compared. Adherence to BP charting among the subjects was also observed.</div></div><div><h3>Results</h3><div>The mean gestational age of study subjects was 34 ± 1.32 weeks. PE developed in 75/170 (44.1 %) subjects. A total of 148/170 (87.0 %) cases were found to be ≥ 80 % compliant in taking BP recordings and attending weekly antenatal checkup. The comparison of outcome in compliant and noncompliant women showed that the incidence of preeclampsia and its complications were significantly higher among non-compliant group (p < 0.001). The mean systolic and diastolic BP in the HBPM cases were marginally higher than controls, but the difference was not statistically significant. The duration of hospital stay in was significantly less in HBPM group compared to controls (4.0 ± 1.49 versus 4.14 ± 1.12) (p = 0.015). The incidence of PE and its complications were comparable in both the groups.</div></div><div><h3>Conclusion</h3><div>The optimum BP control in women could be achieved on HBPM, and was as effective as the standard care protocol. Adherence to BP monitoring was the most important factor in preventing complications and providing benefits of HBPM.</div></div><div><h3>Clinical trial registry details</h3><div>clinical trial registry-India; Registration no CTRI/2022/09/045801, https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=NzQ0OTA=&Enc=&userName=home%20blood%20pressure%20monitoring.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"39 ","pages":"Article 101201"},"PeriodicalIF":2.5000,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2210778925000170","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective
To find the feasibility of home BP monitoring (HBPM) in hypertensive disorders of pregnancy (HDP) in a developing country setting.
Methods
In this randomized control trial 170 women with HDP between 32–36 week gestation were recruited. HBPM was done in cases and controls underwent biweekly blood pressure (BP) monitoring by clinician, randomization was done by computer-generated numbers in 1:1 ratio. The BP levels, frequency of antenatal visits, duration of hospital stay and delivery outcome of cases and controls were compared. Adherence to BP charting among the subjects was also observed.
Results
The mean gestational age of study subjects was 34 ± 1.32 weeks. PE developed in 75/170 (44.1 %) subjects. A total of 148/170 (87.0 %) cases were found to be ≥ 80 % compliant in taking BP recordings and attending weekly antenatal checkup. The comparison of outcome in compliant and noncompliant women showed that the incidence of preeclampsia and its complications were significantly higher among non-compliant group (p < 0.001). The mean systolic and diastolic BP in the HBPM cases were marginally higher than controls, but the difference was not statistically significant. The duration of hospital stay in was significantly less in HBPM group compared to controls (4.0 ± 1.49 versus 4.14 ± 1.12) (p = 0.015). The incidence of PE and its complications were comparable in both the groups.
Conclusion
The optimum BP control in women could be achieved on HBPM, and was as effective as the standard care protocol. Adherence to BP monitoring was the most important factor in preventing complications and providing benefits of HBPM.
Clinical trial registry details
clinical trial registry-India; Registration no CTRI/2022/09/045801, https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=NzQ0OTA=&Enc=&userName=home%20blood%20pressure%20monitoring.
期刊介绍:
Pregnancy Hypertension: An International Journal of Women''s Cardiovascular Health aims to stimulate research in the field of hypertension in pregnancy, disseminate the useful results of such research, and advance education in the field.
We publish articles pertaining to human and animal blood pressure during gestation, hypertension during gestation including physiology of circulatory control, pathophysiology, methodology, therapy or any other material relevant to the relationship between elevated blood pressure and pregnancy. The subtitle reflects the wider aspects of studying hypertension in pregnancy thus we also publish articles on in utero programming, nutrition, long term effects of hypertension in pregnancy on cardiovascular health and other research that helps our understanding of the etiology or consequences of hypertension in pregnancy. Case reports are not published unless of exceptional/outstanding importance to the field.