Introduction Conclusion

References

Results

Hypothesis

Study Design

• Hypertension complicates 6-10% of pregnancies worldwide [1].

• The incidence of de novo postpartum

hypertension or preeclampsia ranges

from 0.3-27.5%. [2]

• Current ACOG recommendations

suggest inpatient blood pressure (BP)

monitoring through 72 hours

postpartum and again at 7-10 days

outpatient [3].

• It is known that BP in the postpartum

period decreases within 48 hours

postpartum, but then increases again

between 3-6 days postpartum [4].

• We hypothesized that blood pressure exacerbation might occur earlier in

the postpartum period than 7-10 days

postpartum.

• A secondary analysis of a nonrandomized controlled trial [4].

• Inclusion criteria: Women with HDP

who delivered at a single midwestern

academic center between 3/2017 and

6/2018.

• BP values of 214 telehealth and 214 control participants were recorded

intrapartum through 42 days

postpartum using home telehealth BP

monitoring.

• Mean systolic and diastolic BPs were calculated for each day.

1. Report of the National High Blood Pressure Education

Program Working Group on High Blood Pressure in

Pregnancy. Am J Obstet Gynecol Jul 2000; 183(1):S1–

S22.

2. SIBAI BM. Etiology and management of postpartum

hypertension-preeclampsia. Am J Obstet Gynecol

2012;206:470-5.

3. Hypertension in pregnancy. Report of the American

College of Obstetricians and Gynecologists' Task Force

on Hypertension in Pregnancy. Obstet Gynecol

2013;122:1122-31.

4. Walters BN, Walters T. Hypertension in the

puerperium. Lancet 1987; 2:330.

• Postpartum hypertension exacerbation is common outpatient and most often before

postpartum day 7 (1st postpartum clinic

visit).

• Postpartum BP increase should be expected

on days 3-5 postpartum.

• Women with chronic hypertension

demonstrate more labile postpartum BP

profile, which warrants close follow up of all

chronic hypertensive women postpartum.

• Reconsidering of current guidelines in order

to provide safe and efficient postpartum care

is required.

WE RECOMMEND:

• Daily BP monitoring through the 1st week

postpartum for women with HDP which

could be done through the home telehealth

with remote BP monitoring

OR

• Scheduling 1st postpartum clinic visit to the

earlier date than 7-10 days postpartum.

Figure 1: Blood pressure

(BP) profile of women with

and without hypertension

exacerbation requiring

postpartum (PP) anti-

hypertensive treatment. A:

mean systolic BP values. B:

mean diastolic BP values.

(*) indicates significant

differences between groups,

p