Real World Impact on Consultation Burden and Clinical Outcomes of Remote Blood Pressure Telemonitoring in Hypertensive Disorders of Pregnancy

Objective: Hypertensive disorders of pregnancy require close blood pressure surveillance and timely therapeutic escalation, yet repeated face to face visits increase patient burden and strain outpatient resources. We evaluated the feasibility and clinical impact of a remote blood pressure telemonitoring pathway in a multidisciplinary hypertensive disorders of pregnancy clinic. Design and method: Retrospective single centre cohort study including 38 consecutive pregnant women referred for hypertensive disorders of pregnancy consultation. Group A comprised the first 19 women enrolled in a structured telemonitoring protocol. Participants received a validated upper arm blood pressure monitor, standardized training, and transmitted home readings via a secure digital platform reviewed by clinicians. Group B included the last 19 women managed immediately before telemonitoring implementation with standard in person follow up. The primary endpoint was the number of in person consultations. Secondary endpoints included baseline office blood pressure, twenty four hour ambulatory blood pressure indices, and maternal fetal events. Results: Median age was 34.5 years; 34.2 percent were primigravida. Group A required fewer in person consultations compared with Group B (2.68±1.53 versus 3.84±1.68), representing a 30 percent relative reduction (p=0.02). Baseline office and ambulatory blood pressure indices did not differ significantly between groups. The telemonitoring group was older and had a higher maternal fetal risk factor burden. The proportion experiencing any maternal fetal event was similar between groups (68.4 percent versus 63.2 percent; p=0.732). Preeclampsia occurred more frequently in Group A (36.8 percent versus 5.3 percent; p=0.042), likely reflecting baseline risk differences rather than an adverse effect of telemonitoring. Conclusions: Remote blood pressure telemonitoring was feasible and associated with a significant reduction in routine in person consultations without worsening blood pressure control or overall maternal fetal event rates, despite a higher risk profile in the telemonitoring group. These findings support further prospective evaluation of telemonitoring integrated into combined cardiology obstetric care pathways.