Computerized home telemetry of maternal blood pressure in hypertensive pregnancy

Abstract

We have developed a telemetric technique whereby maternal blood pressure, which is self-measured by pregnant women in their own homes using a Dinamap 1846 automated blood pressure recorder, can then be transmitted over the commercial telephone network into the Rosie Maternity Hospital in Cambridge, where it is computer-processed. The maternal blood pressure is then reviewed by the obstetrician as part of the clinical management protocol. We have used this telemetric technique on 90 occasions, from the homes of 10 pregnant hypertensive women. On almost every occasion, the blood pressure measured at home was lower than that previously measured in the hospital antenatal clinic. This technique offers great promise, both in terms of health economics and also in terms of reducing pregnant women's unhappiness about their being admitted to hospital whenever they exhibit moderate to severe hypertension in the antenatal clinic. Indeed, in the antenatal period, home telemetry should allow the vast majority of hypertensive pregnancies to be managed just as safely at home as in hospital. In the management of high risk pregnancy, home telemetry of maternal blood pressure complements three other home telemetric techniques which have already been described: fetal heart rate, maternal blood glucose and uterine contractions.