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Aims: 

Good blood pressure control in the mother is crucial during pregnancy for the health of both the mother and baby.

OPTIMUM-BP will develop a method for women with high blood pressure to monitor their own blood pressure at home in addition to their usual antenatal care. 

Why this is important:

Raised blood pressure is a common problem in pregnancy and up to 1 in 20 women enter pregnancy with underlying high blood pressure, and a similar number will develop raised blood pressure during pregnancy. These women are at greater risk of developing complications including pre-eclampsia (a condition developing in the second half of pregnancy, which can lead to women having seizures), kidney and blood clotting problems and even stroke. Their babies can be affected too and are at higher risk for being small or dying before birth.

Self-monitoring blood pressure at home could lead to earlier detection of rising blood pressure, leading to faster diagnosis and treatment." - Dr Louise Pealing, University of Oxford.

Currently women who are at higher risk for developing blood pressure problems during pregnancy are monitored with more frequent antenatal clinic visits. But women can rapidly develop severe disease between these visits, and clinical teams only have the few intermittent clinic readings to make decisions about how best to treat any raised blood pressure.

Women self-monitoring their blood pressure at home may be able to detect rising blood pressure sooner leading to earlier diagnosis and treatment helping prevent any complications. Clinicians will be able to use the home blood pressure readings taken by these women to make more informed treatment decisions

Methods:

OPTIMUM-BP is a randomised controlled feasibility study. 

Pregnant women with high blood pressure will be recruited during their pregnancy and will be randomly assigned to one of two groups. One group will self-monitor their blood pressure at home in addition to usual antenatal care and the other group will continue with usual antenatal care. The self-monitoring group will record their home blood pressures throughout their pregnancy, which the clinical teams will use when making decisions around treatment. The usual care group will continue to have their blood pressure monitored in clinic with clinical teams using these clinic readings to make treatment decisions.

The study will compare the two groups of women for their blood pressure control during pregnancy in addition to looking at other mother and baby outcomes and effects on the health system.

Antenatal clinics will be observed to understand more about how the home blood pressure readings are used to make treatment decisions and women and their clinical teams will be interviewed to explore their experiences of using blood pressure self-monitoring. 

How this could benefit patients:

Women self-monitoring their blood pressure at home may be able to detect rising blood pressure sooner leading to earlier diagnosis and treatment helping prevent any complications.

Next steps:

The study will start recruitment in November 2015.

OPTIMUM-BP

Further information:

Full project title: OPTIMUM-BP:Optimising Titration and Monitoring of Maternal Blood Pressure

Length of the project: 3 years

Funded by:

NIHR

External collaborators:

Relevant pilot studies:

The BuMP Study