PDF(Pubmed)
Abstract：
Postpartum hypertension (PPHT) is hypertension that persists or develops after delivery and is a frequent cause of readmission, affecting 10% of pregnancies. This interim analysis aims to describe the cohort and to determine the feasibility and acceptance of a home-based telemonitoring management strategy (HBTMS) in PPHT patients. Enrollment at the University Hospital Basel began during the 2020 SARS-CoV-2 pandemic. Maternity-ward patients were screened for preexisting hypertension, hypertensive disorders of pregnancy, and de novo PPHT. In this pragmatic non-randomized prospective trial, the participants chose the HBTMS or standard of care (SOC), which consisted of outpatient hypertension clinic appointments. The HBTMS was a smartphone application or a programmed spreadsheet to report blood pressure (BP), followed by telephone consultations. Three months postpartum, the participants underwent a 24 h BP measurement and a blood, biomarker, and urine analysis. A total of 311 participants were enrolled between 06/20 and 08/23. The mean age was 34 (±5.3) years. The current pregnancy history demonstrated the following (≥1 diagnosis possible): 10% had preexisting hypertension, 27.3% gestational hypertension, 53% preeclampsia (PE), 0.3% eclampsia, 6% HELLP (hemolysis, elevated liver enzymes, and low platelets), and 18.3% de novo PPHT. A family history of cardiovascular disease and PE was reported in 49.5% and 7.5%, respectively. In total, 23.3% were high-risk for PE. A total of 68.5% delivered via c-section, the mean hospitalization was 6.3 days (±3.9), and newborn intrauterine growth restriction occurred in 21%. A total of 99% of the participants chose the HBTMS. This analysis demonstrated that the HBTMS was accepted. This is vital in the immediate postpartum period and pertinent when the exposure of hospital visits should be avoided.
摘要：
产后高血压（PPHT）是指分娩后持续或发展的高血压，是再入院的常见原因。影响10%的怀孕。本中期分析旨在描述队列，并确定PPHT患者中基于家庭的远程监护管理策略（HBTMS）的可行性和接受程度。巴塞尔大学医院的入学始于2020年SARS-CoV-2大流行期间。对产科病房患者进行了先前存在的高血压筛查，妊娠高血压疾病，和从头PPHT。在这项实用的非随机前瞻性试验中，参与者选择了HBTMS或护理标准(SOC)，其中包括门诊高血压诊所预约。HBTMS是智能手机应用程序或编程的电子表格报告血压（BP），随后进行电话咨询。产后三个月,参与者接受了24小时血压测量和血液，生物标志物，尿液分析。共有311名参与者在06/20和08/23之间登记。平均年龄34(±5.3)岁。目前的妊娠史证明了以下（≥1诊断可能）：10％有预先存在的高血压，27.3%妊娠期高血压,53%子痫前期（PE），0.3%子痫,6%HELLP（溶血，肝酶升高，和低血小板)，和18.3%从头PPHT。有心血管疾病和PE家族史的占49.5%和7.5%，分别。总的来说,23.3%为PE高风险。共有68.5%通过剖腹产交付，平均住院时间为6.3天（±3.9），新生儿宫内生长受限发生率为21%。共有99%的参与者选择了HBTMS。该分析表明HBTMS被接受。这在产后初期至关重要，并且在应避免住院时至关重要。
