Hans van den Heuvel

10 intravenous therapeutics or expected obstetric intervention within 48 hours; (2) current blood pressure >160/110 mmHg; (3) active antepartum haemorrhage or signs of placental abruption; (4) CTG registration with abnormalities indicating fetal distress or hypoxia; (5) place of residence > 30 minutes travel distance from a hospital; (6) multiple pregnancy; (7) insufficient knowledge of Dutch or English language or impossibility to understand training or instructions of telemonitoring devices. Recruitment and randomisation Eligible women will be approached and informed by obstetric care professionals i.e. physicians, (research) midwives or research nurses. Following counselling and sufficient time for questions, written informed consent is obtained and participants will be randomly allocated in a 50:50 ratio to either hospital admission or telemonitoring. Randomisation will be performed through a secured web-based domain (Research Online, Julius Research Support, UMC Utrecht) and will be stratified for 6 diagnoses for inclusion and 6 centres of inclusion. Block randomisation with variable block sizes is used. Cross over of trial arm is not permitted and will be considered a protocol violation. An overview of the study procedures is shown in Figure 1. Table 1 Additional information on inclusion criteria. Inclusion criteria Additional definitions or criteria (other than exclusion criteria) 1 Preeclampsia Defined as: - hypertension (diastolic blood pressure > 90 mmHg and/or systolic blood pressure > 140 mmHg with proteinuria following ISSHP criteria at the time of study design (FGR is defined below) 13 - no restriction on use of oral antihypertensive medication 2 Preterm rupture of membranes - No present contractions - cephalic or breech position, with engaged fetal head or breech 3 Fetal growth restriction Defined as: - fetal abdominal circumference (fAC) or estimated fetal weight (EFW) <10th percentile and abnormal Doppler sonography assessment defined as pulsatility index (PI) of umbilical artery >p95 and/ or absence or reversed end diastolic flow velocity flow of umbilical artery - fAC or EFW <p3 with or without abnormal umbilical artery Doppler flow 4 Recurrent reduced fetal movements 5 Fetal anomaly requiring daily monitoring 6 Intrauterine fetal death in previous pregnancy HOTEL TRIAL STUDY PROTOCOL 167