Self antenatal monitoring of blood pressure at home as interVention (SAMBHAV) in hypertensive women: Challenges in the developing country.

OBJECTIVE

To find the feasibility of home BP monitoring (HBPM) in hypertensive disorders of pregnancy (HDP) in a developing country setting.

METHODS

In this randomized control trial 170 women with HDP between 32-36 week gestation were recruited. HBPM was done in cases and controls underwent biweekly blood pressure (BP) monitoring by clinician, randomization was done by computer-generated numbers in 1:1 ratio. The BP levels, frequency of antenatal visits, duration of hospital stay and delivery outcome of cases and controls were compared. Adherence to BP charting among the subjects was also observed.

RESULTS

The mean gestational age of study subjects was 34 ± 1.32 weeks. PE developed in 75/170 (44.1 %) subjects. A total of 148/170 (87.0 %) cases were found to be ≥ 80 % compliant in taking BP recordings and attending weekly antenatal checkup. The comparison of outcome in compliant and noncompliant women showed that the incidence of preeclampsia and its complications were significantly higher among non-compliant group (p < 0.001). The mean systolic and diastolic BP in the HBPM cases were marginally higher than controls, but the difference was not statistically significant. The duration of hospital stay in was significantly less in HBPM group compared to controls (4.0 ± 1.49 versus 4.14 ± 1.12) (p = 0.015). The incidence of PE and its complications were comparable in both the groups.

CONCLUSION

The optimum BP control in women could be achieved on HBPM, and was as effective as the standard care protocol. Adherence to BP monitoring was the most important factor in preventing complications and providing benefits of HBPM. CLINICAL TRIAL REGISTRY DETAILS: clinical trial registry-India; Registration no CTRI/2022/09/045801, https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=NzQ0OTA=&Enc=&userName=home%20blood%20pressure%20monitoring.