Hans van den Heuvel

3 INTRODUCTION The proportion of women at increased risk for hypertension in pregnancy is growing, caused by factors such as life style, obesity, advanced maternal age at conception and concurrent heart or kidney disease .1 Accurate blood pressure (BP) measurement is essential for diagnosis and management of hypertension in pregnancy. In clinical practice, BP is measured using auscultatory sphygmomanometry or using automated devices validated for use in pregnancy. Besides clinical measurements, self monitoring of BP in pregnancy is increasingly popular with both health care professionals and patients. Guidelines now recommend home monitoring for patients with chronic hypertension and gestational hypertension. 2,3 Possible advantages of home monitoring include the potential to rule out white coat hypertension, reduce the burden and costs of clinic visits and enhance patient satisfaction and autonomy. 1 With help of telemonitoring, women at high risk for or even established hypertensive disorders of pregnancy (HDP) or preeclampsia canbemonitored (more) frequentlywithout interfering all toomuchwithdailyactivities. 4 Patients’acceptabilityandwillingnessforhomebloodpressure measurements is generally good, as they report increased reassurance, empowerment and less anxiety. 5 Professional guidelines regarding preeclampsia caution against automated blood pressure measuring devices for establishing the diagnosis of preeclampsia and institution of treatment, because both overestimation as well as underestimation of blood pressure (BP) can occur in comparison with auscultatory measurements. 3, 6 While numerous automated BP devices are freely available, few monitors are validated for accurate use in pregnancy with or without hypertensive disorders such as preeclampsia. It is essential that new devices are compared to gold standard measurement methods to rule out over- or underestimation of BP values during pregnancy. Previous studies found several home monitors valid for use in pregnant women, according to different international validation protocols. 7-9 Other devices did not pass validation requirements recently and are therefore not recommended for use in pregnancy. 10 In order to offer pregnant patients an automated BP device with an integrated platform for telemonitoring of blood pressure, we chose to assess the validity of two devices according to the revised 2010 International Protocol of the European Hypertension Society. 11 VALIDATION STUDY OF TWO BLOOD PRESSURE MONITORS IN PREGNANCY 41