Rationale
Complications from hypertensive disorders of pregnancy (HDP) is a leading cause of severe maternal morbidity and postpartum readmission. HDP, including chronic hypertension, gestational hypertension, and preeclampsia/eclampsia, occur frequently and complicate approximately 10% of all pregnancies.
Hypertension also disproportionately affects more vulnerable families, as publicly insured people and those from racial/ethnic minority groups are more likely to be readmitted — interrupting crucial family bonding time and stressing the medical system.
HDP represents a “window of opportunity” for acute blood pressure (BP) management and initiating measures to prevent the recurrence of HDP, facilitating early prevention of cardiovascular disease, and eliminating inequities in severe maternal morbidity.
A silver lining of the COVID-19 pandemic is that it has led many health systems and patients to use virtual health care with success, patient satisfaction, and insurance coverage. Although existing literature on home postpartum BP monitoring is limited, recent data suggests that it is achievable and cost-effective.
The American College of Obstetricians and Gynecologists (ACOG) recommends a BP check within one week of delivery for all birthing people with hypertensive disorders of pregnancy or within 72 hours if the pregnancy was complicated by severe hypertension.
Our Project
Massachusetts Department of Public Health (MDPH) will collaborate with Baystate Medical Center in Western, MA, and Brigham and Women’s Hospital in Boston to implement the Babyscripts remote patient monitoring program for all delivering patients diagnosed with hypertensive disorders of pregnancy.
The Babyscripts Program is a smartphone-based app that delivers educational content to patients and provides a platform for remote blood pressure monitoring. Patients would be enrolled while still in the hospital and given a blue tooth-enabled blood pressure (BP) cuff prior to discharge which interfaces with the app.
Babyscripts monitors data in real-time and notifies the patients’ practice anytime an established trigger is met (i.e., severe range blood pressure, mild range blood pressure with symptoms). Practices can then promptly connect with patients to establish a plan of care responsive to elevated blood pressure readings and/or symptomatic concerns.
Want to learn more about interventions for Hypertensive Disorders of Pregnancy?
- Visit the Massachusetts AIM Initiative page for more information about the Severe Hypertension bundle (implemented January-June 2022).
- Explore the Severe Hypertension resources in our Resource Library.