Early Detection and Intervention of Postpartum Preeclampsia With the Use of Mobile and Digital Tools [29E

Abstract

INTRODUCTION: Hypertensive disorders in pregnancy are a leading cause of morbidity and mortality. This case series examines the ability of an integrated technology platform to augment surveillance with remote blood pressure (BP) readings in low-risk pregnant women and allow for real time intervention by providers of care. METHODS: Pregnant women presented at the clinic of an urban academic medical center. Patients were placed on an optimized prenatal care plan that consisted of an alternative in-clinic visit schedule and an integrated technology platform, provided by a mobile/digital health firm. Patients used the mobile app as well as collected weight and BP data weekly. The platform includes advanced remote monitoring technology to identify aberrant data points. A “trigger alert” mechanism alerts clinicians when aberrant data points are identified and enable the early detection of certain high-risk conditions, such as preeclampsia. Case 1: Patient 1, G3P1010 recorded 26 BPs antenatally; all BPs were less than 140/90. Postpartum, BPs were elevated and led to hospital readmission for magnesium sulfate. Case 2: Patient 2, G3P0020 recorded 21 BPs antenatally; all BPs were less than 140/90. Postpartum, BPs were elevated and led to hospital readmission for magnesium sulfate. 15 BPs were recorded after discharged and antihypertensives were titrated according to these data points. CONCLUSION: Remote monitoring of BP in low-risk pregnant women resulted in frequent recordings during the antepartum and postpartum periods. Remote monitoring of BP could offer more robust monitoring in low-risk pregnancies and allow for real time identification and intervention of high blood pressure.