Can Blood Pressure Self-Monitoring Improve Postpartum Management of Pregnancy-Associated Hypertension?
See related article, pp 425–432
Hypertensive disorders of pregnancy, including gestational hypertension and preeclampsia, affect 5% to 12% of all pregnancies around the globe and are a leading cause of maternal morbidity and mortality.1 Although delivery of the fetus and placenta remains the only definitive treatment for preeclampsia, the sequalae do not end with delivery. Hypertensive disorders of pregnancy are long lasting and multigenerational: women with preeclampsia are at increased risk for future hypertension, cardiovascular disease, and end-stage renal disease; their offspring, if born premature or at low birth weight, are at increased risk for chronic disease in adulthood.2,3 Clinical trials on the treatment and monitoring of hypertensive disorders of pregnancy have focused on the antepartum period. Historically, it was believed that blood pressure would progressively resolve with removal of the placenta, and few studies have addressed the issue of hypertension in the postpartum period. Now, there is recognition that hypertensive disorders of pregnancy can persist after delivery or arise newly postpartum, and many women treated for preeclampsia or gestational hypertension require large doses of antihypertensive medications after delivery.
In the current …