Changes to management of hypertension in pregnancy, and attitudes to self-management: An online survey of obstetricians, before and following the first wave of the COVID-19 pandemic

B. Fletcher, L. C. Chappell, L. Lavallee, H. M. Wilson, R. Stevens, L. Mackillop, R. J. McManus, K. L. Tucker*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)

Abstract

Objective: This study aimed to understand the views and practice of obstetricians regarding self-monitoring for hypertensive disorders of pregnancy (blood pressure (BP) and proteinuria), the potential for self-management (including actions taken on self-monitored parameters) and to understand the impact of the COVID-19 pandemic on such views. Design: Cross-sectional online survey pre- and post- the first wave of the COVID-19 pandemic. Setting and Sample: UK obstetricians recruited via an online portal. Methods: A survey undertaken in two rounds: December 2019-January 2020 (pre-pandemic), and September-November 2020 (during pandemic) Results: 251 responses were received across rounds one (1 5 0) and two (1 0 1). Most obstetricians considered that self-monitoring of BP and home urinalysis had a role in guiding clinical decisions and this increased significantly following the first wave of the COVID-19 pandemic (88%, (132/150) 95%CI: 83–93% first round vs 96% (95%CI: 92–94%), (97/101), second round; p = 0.039). Following the pandemic, nearly half were agreeable to women self-managing their hypertension by using their own readings to make a pre-agreed medication change themselves (47%, 47/101 (95%CI: 37–57%)). Conclusions: A substantial majority of UK obstetricians considered that self-monitoring had a role in the management of pregnancy hypertension and this increased following the pandemic. Around half are now supportive of women having a wider role in self-management of hypertensive treatment. Maximising the potential of such changes in pregnancy hypertension management requires further work to understand how to fully integrate women's own measurements into clinical care.

Original languageEnglish
Pages (from-to)54-61
Number of pages8
JournalPregnancy Hypertension
Volume26
DOIs
Publication statusPublished - 1 Sept 2021

Keywords

  • Hypertension
  • PRE-eclampsia
  • Pregnancy
  • Self-management
  • Self-monitoring

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