Hypertension in pregnancy managed at home by community midwives

Abstract

In recent years the importance of providing antenatal care at home has been increasingly emphasised, and most clinicians have become increasingly reluctant to admit pregnant women to hospital except when absolutely necessary. Although there is good evidence that admission to hospital and bed rest do not improve the fetal prognosis in pregnant women with hypertension, many obstetricians have nevertheless continued with a policy of admission for uncomplicated hypertension in pregnancy to ensure close observation of the patient and to note any proteinuria. Midwives, however, can monitor patients closely at home and obtain more accurate readings of blood pressure (in some hypertensive states readings of systolic blood pressures noted in hospital tend to be about 10 mm Hg higher than those noted at home).