Josephus F M van den Heuvel1, A Titia Lely2, Jolijn J Huisman3, Jaap C A Trappenburg4, Arie Franx5, Mireille N Bekker6. 1. Department of Obstetrics and Gynaecology, University Medical Center Utrecht, Utrecht University, Lundlaan 6, 3508 AB Utrecht, the Netherlands. Electronic address: J.f.m.vandenheuvel-11@umcutrecht.nl. 2. Department of Obstetrics and Gynaecology, University Medical Center Utrecht, Utrecht University, Lundlaan 6, 3508 AB Utrecht, the Netherlands. Electronic address: a.t.lely@umcutrecht.nl. 3. Department of Obstetrics and Gynaecology, Diakonessenhuis, Bosboomstraat 1, 3582 KE Utrecht, the Netherlands. Electronic address: jhuisman@diakhuis.nl. 4. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands. Electronic address: j.c.a.trappenburg@umcutrecht.nl. 5. Department of Obstetrics and Gynaecology, University Medical Center Utrecht, Utrecht University, Lundlaan 6, 3508 AB Utrecht, the Netherlands; Department of Obstetrics and Gynaecology, Erasmus Medical Center, Erasmus University, Dr. Molewaterplein 40, 3015 GD Rotterdam, the Netherlands. Electronic address: a.franx@erasmusmc.nl. 6. Department of Obstetrics and Gynaecology, University Medical Center Utrecht, Utrecht University, Lundlaan 6, 3508 AB Utrecht, the Netherlands. Electronic address: m.n.bekker-3@umcutrecht.nl.
Abstract
OBJECTIVE: In women at risk of developing preeclampsia, we evaluated the use of a digital health platform for telemonitoring blood pressure and symptoms combined with a minimal antenatal visit schedule. STUDY DESIGN: A case-control study for women with chronic hypertension, history of preeclampsia, or maternal cardiac or kidney disease. A care path was designed with reduced visits enhanced with a digital platform (SAFE@HOME) for daily blood pressure and symptom monitoring starting from 16 weeks of gestation. Home-measurements were monitored in-hospital by obstetric professionals, taking actions upon alarming results. This prospective SAFE@HOME group was compared to a retrospective control group managed without self-monitoring. MAIN OUTCOME MEASURES: Primary: healthcare consumption (number of antenatal visits, ultrasounds, admissions and diagnostics), user experiences of the platform. Secondary: maternal and perinatal outcomes. RESULTS: Baseline characteristics of the SAFE@HOME (n = 103) and control group (n = 133) were comparable. In the SAFE@HOME group, antenatal visits (mean 13.7 vs 16.0, p < 0.001) and ultrasounds (6.3 vs 7.4, p = 0.005) were lower compared to the control group. Admissions for hypertension or suspected preeclampsia were significantly fewer in the SAFE@HOME group (2.9% versus 13.5%, p = 0.004). Telemonitoring participants were highly satisfied using the platform. No differences were observed for maternal and perinatal outcomes. CONCLUSIONS: Our care path including blood pressure telemonitoring for women at risk of preeclampsia allows fewer antenatal visits, ultrasounds and hypertension-related admissions. We observed no differences in perinatal outcomes. These results suggest that telemonitoring of blood pressure is feasible in a high-risk pregnant population and has the potential to profoundly change antenatal care.
OBJECTIVE: In women at risk of developing preeclampsia, we evaluated the use of a digital health platform for telemonitoring blood pressure and symptoms combined with a minimal antenatal visit schedule. STUDY DESIGN: A case-control study for women with chronic hypertension, history of preeclampsia, or maternal cardiac or kidney disease. A care path was designed with reduced visits enhanced with a digital platform (SAFE@HOME) for daily blood pressure and symptom monitoring starting from 16 weeks of gestation. Home-measurements were monitored in-hospital by obstetric professionals, taking actions upon alarming results. This prospective SAFE@HOME group was compared to a retrospective control group managed without self-monitoring. MAIN OUTCOME MEASURES: Primary: healthcare consumption (number of antenatal visits, ultrasounds, admissions and diagnostics), user experiences of the platform. Secondary: maternal and perinatal outcomes. RESULTS: Baseline characteristics of the SAFE@HOME (n = 103) and control group (n = 133) were comparable. In the SAFE@HOME group, antenatal visits (mean 13.7 vs 16.0, p < 0.001) and ultrasounds (6.3 vs 7.4, p = 0.005) were lower compared to the control group. Admissions for hypertension or suspected preeclampsia were significantly fewer in the SAFE@HOME group (2.9% versus 13.5%, p = 0.004). Telemonitoring participants were highly satisfied using the platform. No differences were observed for maternal and perinatal outcomes. CONCLUSIONS: Our care path including blood pressure telemonitoring for women at risk of preeclampsia allows fewer antenatal visits, ultrasounds and hypertension-related admissions. We observed no differences in perinatal outcomes. These results suggest that telemonitoring of blood pressure is feasible in a high-risk pregnant population and has the potential to profoundly change antenatal care.
Authors: Anneloek Rauwerdink; Marise J Kasteleyn; Niels H Chavannes; Marlies P Schijven Journal: J Med Internet Res Date: 2021-11-25 Impact factor: 5.428
Authors: Karin Rolanda Jongsma; Josephus F M van den Heuvel; Jasmijn Rake; Annelien L Bredenoord; Mireille N Bekker Journal: JMIR Mhealth Uhealth Date: 2020-08-04 Impact factor: 4.773