Dr Lucy McMullen1, Dr Erin Vaughan1, Dr Sumanthi Rajendran1, Dr Patrick Lan1,2, Dr Jane Tooher1,2, Sarah Everett, Marilena Pelosi, Laura Cunningham1,2, Dr Rajit Narayan1, Professor Jon Hyett1,2
1Royal Prince Alfred Hospital, Camperdown, Australia, 2Sydney Institute for Women, Children and their Families, Camperdown, Australia
Biography:
Dr Lucy McMullen is a Nephrology Advanced Trainee. Her interests are in hypertensive disorders of pregnancy, obstetric nephrology, and improving equity and access to healthcare for regional and rural populations.
Abstract:
Hypertensive disorders of pregnancy (HDP) are leading causes of maternal and perinatal morbidity and mortality that have been traditionally managed through frequent outpatient monitoring. With an objective to assess a patient-centered and resource-optimizing strategy, this study evaluated home blood pressure monitoring (HBPM) as an alternative approach to the standard care for HDP management. The research compared HBPM's influence on the reduction of antenatal visits and hospital admissions against a retrospectively matched control group receiving standard care (36 women vs 72 women, respectively). Measures included HDP-related complications, gestational age at delivery, maternal outcomes, and infant metrics such as NICU admissions and preterm birth rates.
Our analysis demonstrated a decrease in healthcare visits for the HBPM group, without a corresponding increase in adverse outcomes. The number of women in the HBPM group requiring a hospital admission was 6 (17%) compared to 22 (31%) in the control group (p=0.12). The number of women in the HBPM group requiring a day assessment admission was 15 (42%) compared to 51 (71%) in the control group (p=0.03). These findings suggest that HBPM is a reliable strategy for managing HDP, offering a balance between efficient healthcare resource use and maintaining high safety standards for mother and child. The utilization of HBPM also reflected potential improvements in patient autonomy and satisfaction, implicating a positive shift towards patient-managed care.
This study suggests that HBPM is not only a pragmatic response to the need for efficient healthcare delivery but also a sustainable model for future application in antenatal care practices. HBPM could represent a new frontier in empowering patients with HDP, enabling them to actively participate in their healthcare journey while conserving medical resources.