WITHDRAWN: Early identification of hypertensive disorders of pregnancy (An mhealth feasibility study for resource limited settings)

Abstract

Hypertensive Disorders of Pregnancy (HDP) account for 18% of potential preventable maternal deaths in South Africa. MHealth studies on early HDP identification in high income countries showed potential value for limited resource settings. This study aimed to test the feasibility of an mHealth solution for early identification of HDP using self home monitoring of blood pressure (BP) and sharing of information on symptoms of preeclampsia in a low middle income country (LMIC). This mixed methods study, enrolled 100 pregnant women (20 to 30 weeks) to selfmonitor and submit daily BP and pulse readings on a smart phone to an mHealth platform observed by a midwife for targeted action. Information was shared on 7 symptoms of preeclampsia using brochures, posters, targeted digital messages and quizzes. Study data was collected through the mHealth platform, key informant interviews, pre pand post knowledge, attitude and practice (KAP) suveys and self and community health worker’s (CHW) reported outcomes. Ten cases had interventions for HDP in the cohort. All mothers with HDP and their babies had satisfactory outcomes. This was facilitated through the BP monitoring on the App and digital platform, increased knowledge of 7 symptoms of preeclampsia and CHW follow up. The study found in conclusion that pregnant women in resource limited settings are able to self home monitor their BP using a mHealth solution for early identification and management of HDP. The study acknowledge challenges for scale up and cost effectiveness but recognise potential.