ADIPS SOMANZ Combined Oral Australasian Diabetes in Pregnancy Society and Society of Obstetric Medicine Australia and New Zealand Joint Scientific Meeting 2025

Remote blood pressure monitoring in women at high risk of preeclampsia – a randomised controlled trial (REMOTE CONTROL trial) (127622)

Theepika Rajkumar 1 2 3 , Annemarie Hennessy 1 2 , Renuka Shanmugalingam 2 3 4 , Jun Mai 3 , Daniela Potter 3 , Jill Freyne 5 , Kaley Butten 5 , Marlien Varnfield 5 , Angela Makris 2 3 4
  1. Department of Medicine, Campbelltown Hospital, Campbelltown, NSW, Australia
  2. School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
  3. Renal Medicine, Liverpool Hospital, Liverpool, NSW, Australia
  4. University of New South Wales, Sydney, NSW, Australia
  5. Australian e-Health Research Center , Brisbane, Queensland, Australia

Aim: To evaluate whether remote blood pressure monitoring (RBPM) can safely be utilised in pregnant women at high risk of developing preeclampsia.

 

Background: Women at high risk of developing preeclampsia require more frequent  blood pressure (BP) assessments. RBPM allows clinicians to remotely review patients’ home BP readings, offering close surveillance of BP, greater convenience and reducing the need for in-person reviews, however robust safety evidence is limited.

 

Methods: The REMOTE CONTROL trial is a multicentre, non-inferiority, randomised controlled trial, which compares RBPM in high-risk pregnant women with conventional in-person review. Women randomised to RBPM measured their BP using an automated BP machine with data transmitted for clinician review via a customised smartphone application (M♡THer). Women randomised to usual care attended specialist hypertension clinics for additional BP monitoring.

 

Results: 270 women were included in the final analysis. There was no difference in the primary outcome (composite fetal outcome of perinatal loss, high-level neonatal care for >48 hours or small for gestational age) [HR 1.0 95%CI 0.57-1.76; p-value 0.99].

There was also no difference in composite maternal complications [HR 1.01 95%CI 0.52-1.97; p-value 0.97], preeclampsia diagnoses [HR 0.78 95%CI 0.39-1.55; p-value 0.48], and number of deliveries expedited due to hypertension [HR 1.31 95%CI 0.63-2.71; p-value 0.47]. Importantly, women undertaking RBPM had less hospital attendances than those in usual care [p-value<0.01].

 

Conclusions: RBPM is a safe alternative to conventional clinic visits for BP monitoring in high-risk pregnant women, allowing less antenatal hospital attendances without increasing the risk of adverse maternofetal outcomes.