Blood Pressure Monitoring in High Risk Pregnancy to Improve the Detection and Monitoring of Hypertension (BUMP)
Pregnancy, High Risk, Pre-Eclampsia, Hypertension
About this trial
This is an interventional health services research trial for Pregnancy, High Risk
Eligibility Criteria
BUMP 1
Inclusion Criteria:
- Participant is willing and able to give informed consent for participation in the trial
- Pregnant woman, aged 18 years or above between 16+0 to 24+0 weeks
- Able and willing to comply with trial requirements
- Willing to allow her general practitioner and consultant, if appropriate, to be notified of participation in the trial
- At higher risk for hypertension in pregnancy / pre-eclampsia defined as one or more of the following risk factors:
- Age 40 years or older
- Nulliparity
- Pregnancy interval of more than 10 years
- Family history of pre-eclampsia
- Previous history of pre-eclampsia or gestational hypertension
- Body mass index 30 kg/m2 or above at booking
- Chronic kidney disease
- Twin pregnancy
- Diabetes (Type 1&2)
- Autoimmune Disease (eg systemic lupus erythematosis or antiphospholipid disease)
Exclusion Criteria:
- Chronic Hypertension
BUMP 2:
Inclusion Criteria:
• Women developing pregnancy hypertension previously randomised in BUMP 1 (regardless of gestation).
OR
- Women with chronic hypertension (defined as sustained systolic BP≥140 mmHg and/or diastolic BP≥90 mmHg, present at booking or before 20 weeks' gestation, or receiving treatment outside pregnancy and/or at time of referral).
- Recruited up to 37+0 weeks' gestation.
OR
- Women with hypertension after 20 weeks' gestation (defined as sustained systolic BP≥140 mmHg and/or diastolic BP≥90 mmHg).
- Recruited at 20+0 to 37+0 weeks' gestation.
AND
- Participant is willing and able to give informed consent for participation in the trial.
- Woman aged 18 years or above.
- Willing to allow her general practitioner and consultant, if appropriate, to be notified of participation in the trial.
Exclusion criteria:
Anticipated inpatient admission considered likely to lead to imminent delivery (within the next 48 hours)
Sites / Locations
- Buckinghamshire Healthcare NHS Trust
- Birmingham Women's and Children's Hospital NHS Foundation Trust
- Croydon Health Services NHS Trust
- Barts Health NHS Trust
- Kingston Hospital NHS Foundation Trust
- Guy's and St Thomas' NHS Foundation Trust
- King's College Hospital NHS Foundation Trust
- Chelsea and Westminster Hospital NHS Foundation Trust
- St George's University Hospitals NHS Foundation Trust
- Manchester University NHS Foundation Trust
- Oxford University Hospitals NHS Foundation Trust
- The Royal Berkshire NHS Foundation Trust
- The Royal Wolverhampton NHS Trust
Arms of the Study
Arm 1
Arm 2
Experimental
No Intervention
Self-Monitoring of Blood Pressure
Usual Care
BUMP 1: using a validated home blood pressure monitor at least 3 times a week to record blood pressure BUMP 2: using a validated home blood pressure monitor daily to record blood pressure Women in the intervention groups will be encouraged to use a simple mobile tele monitoring system.
Women randomised to usual care will continue to have all their BP monitoring completed by the clinical team at their antenatal assessments.