New mom spends 3 days in hospital with dangerously high blood pressure – found thanks to a home monitoring program
About a week after her daughter Hazel’s birth, Jill Kaiyalethe had a headache. She didn’t think much of it as she took her blood pressure and entered the numbers into an app – as she'd done twice a day since she left the hospital with Hazel.
A care coordinator at M Health Fairview reviewed Jill’s entries and told her that her numbers were high and if that continues, she should get it checked out. Jill's numbers were still high when she next entered her next reading, so a message in the app prompted her to get care. Jill called the Fairview nurse line since it was after clinic hours. The nurse told her to go to the emergency department.
“I thought I was just there for some meds, and they did get me on medication immediately, but also admitted me,” Jill said. “I ended up being there for three days.”
Jill was diagnosed with postpartum preeclampsia, a condition that causes high blood pressure in people who have recently given birth. Preeclampsia can also damage the kidneys or other organs. One sign of preeclampsia is a severe headache.
One in seven people experience high blood pressure disorders of pregnancy during pregnancy or following delivery. The disorders can lead to increased risks of complications including dangerously high blood pressure, stroke, heart failure, and seizure. People of color are disproportionately impacted.
“These risks extend into the weeks following delivery with the postpartum period being one of the highest risk, yet most unsupported, times for new parents,” said Bethany Sabol, MD who created and runs HOPE-BP, the home-monitoring program.
The American College of Obstetrics and Gynecology recommend that patients with high blood pressure disorders of pregnancy have a follow-up blood pressure check three to five days after leaving the hospital. But it’s difficult to get new parents back for blood pressure checks and some people experience dangerously high blood pressure and are admitted to the hospital before their scheduled follow-up.
“In the moment, I don’t think I realized that having such high blood pressure had been so dangerous for my health,” Jill said. “But after being admitted and realizing how serious the situation was, I’m really so thankful that I’m here and can take care of my kids and be a healthy mom.”
HOPE-BP program allows monitoring from home
Jill’s blood pressure was a little bit elevated after Hazel’s birth in January 2024. Her nurse told Jill about the new Home Observation of Postpartum Elevated Blood Pressure (HOPE-BP) program, which launched at M Health Fairview University of Minnesota Medical Center in November 2023.
Twice a day, Jill would be prompted by an app to take her blood pressure and enter the numbers in MyChart, the M Health Fairview online patient account. Her care team would monitor the numbers.
“It was something I could do from home with an infant,” said Jill, who is also mom to an 8-year-old and a 6-year-old. “With just having a baby and so much going on and not getting enough sleep, it helps that someone’s on the other end, making sure you’re submitting the numbers and an app that reminds you because I don’t know that I would have done it twice a day.”
The HOPE-BP program was designed to help birthing people stay safe and feel supported and empowered – despite this scary diagnosis – from the comfort of their homes. By providing monitoring equipment and coordinating virtual follow-up care at no cost, the initiative aims to reach communities most impacted by high blood pressure disorders of pregnancy, especially new birthing people who may lack access to reliable transportation or face other barriers to care.
The program has had 367 participants so far. Early results show a 69% reduction in postpartum readmissions due to hypertension with over 88% of participating patients providing a blood pressure reading within the first 72 hours of discharge.
“This is a great start, and we feel really optimistic about the potential of this program, but we still have a long way to go” Sabol said. “While the program is currently available only at the University of Minnesota Medical Center, we are hoping to get support to expand this across our entire system starting in 2025. We also recognize that a significant barrier to achieving equitable outcomes is not being able to offer this program in languages other than English so we are actively working on a solution to that.”
For Jill, the program allowed her to get care quickly. She took blood pressure medication for about six months before it returned to normal.
