Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
MedStar Washington Hospital Center, Georgetown University, Washington, District of Columbia, USA.
J Clin Hypertens (Greenwich). 2024 Sep;26(9):1015-1023. doi: 10.1111/jch.14886. Epub 2024 Aug 26.
Hypertensive disorders of pregnancy pose significant risks to both maternal and fetal health. Postpartum hypertension, a common complication, often leads to emergency room (ER) visits or hospital readmissions. Despite the prevalence of these complications, there is a paucity of studies that focus on blood pressure monitoring in postpartum patients with de novo hypertensive disorders of pregnancy. This review aimed to address the gap by evaluating available evidence to compare telehealth monitoring with in-person visits in preventing ER visits and hospital readmissions among postpartum patients with de novo hypertensive disorders of pregnancy. The study identified relevant studies by conducting a rigorous search strategy (Medline/OVID, the Cochrane Library, Scopus, and research registries such as the International Clinical Trials Registry Platform [ICTRP] and clinical trials) directed by the clinical information specialist. Two reviewers independently screened titles and abstracts, resolving discrepancies with the assistance of a third reviewer. Data extraction followed standardized protocols, and risk of bias assessments were conducted using appropriate tools. This rapid review synthesized evidence from 11 studies on telehealth for women with recent de novo hypertensive disorders of pregnancy. Findings highlighted that telemonitoring led to earlier blood pressure documentation and intervention, reduced disparities in blood pressure measurement, decreased hypertension-related readmissions, higher rates of postpartum antihypertensive treatment initiation, and increased patient satisfaction. Telehealth emerges as a promising tool for managing postpartum hypertension among women with recent de novo hypertensive disorders of pregnancy.
妊娠高血压疾病对母婴健康都构成重大威胁。产后高血压是一种常见的并发症,常导致急诊室(ER)就诊或住院再次入院。尽管这些并发症很常见,但很少有研究关注新诊断妊娠高血压疾病的产后患者的血压监测。本综述旨在通过评估现有证据来解决这一差距,比较远程医疗监测与面对面就诊在预防新诊断妊娠高血压疾病的产后患者 ER 就诊和住院再次入院方面的效果。研究人员通过临床信息专家指导的严格搜索策略(Medline/OVID、Cochrane 图书馆、Scopus 和研究登记处,如国际临床试验注册平台(ICTRP)和临床试验)来确定相关研究。两名评审员独立筛选标题和摘要,并在第三名评审员的协助下解决分歧。数据提取遵循标准化协议,使用适当的工具进行偏倚风险评估。这项快速综述综合了 11 项关于新诊断妊娠高血压疾病女性远程医疗的研究证据。研究结果强调,远程监测可更早地记录和干预血压,减少血压测量的差异,降低与高血压相关的再次入院率,提高产后降压治疗的起始率,并增加患者满意度。远程医疗成为管理新诊断妊娠高血压疾病女性产后高血压的有前途的工具。