Articles

Key takeaways

• Do not use home fetal dopplers to check your baby's health.
• Home blood pressure and urine monitoring can be safe with guidance.
• Some monitoring helps detect conditions like pre-eclampsia early.
• Always discuss home monitoring with your maternity care team.

An introduction to home monitoring in pregnancy

Home monitoring involves using devices to track aspects of your pregnancy. These can include devices like blood pressure monitors, urine testing kits, and sometimes even fetal dopplers.

A warning about home fetal dopplers

A doppler is a small, portable machine. It uses a sensor that you place on your abdomen to listen to your baby’s heartbeat using ultrasound waves. It is important not to use these hand-held monitors at home.

This also includes stethoscopes or phone apps to check your baby's heartbeat. These devices are not a reliable way to check your baby's health.

Hearing a heartbeat on a home doppler is not a reliable sign of your baby's wellbeing. A heartbeat on its own doesn't tell you everything about your baby's wellbeing.

It's always best to let your maternity team check on your baby, as they can see the whole picture of your baby's health.

Home blood pressure and urine monitoring

Monitoring your blood pressure and urine at home can be safe. It may be suggested to you as part of your ongoing care with your maternity team. They will help you decide if home monitoring is right for you.

It is safe even if you have a higher chance of developing pre-eclampsia. Equipment may be provided for you to use at home. It will be explained why monitoring could be important, specifically for you and your baby.

Why home monitoring is important

If you have both high blood pressure and protein in your urine, it can be a sign of a developing condition called pre-eclampsia. This is a serious disorder that needs to be monitored closely by your care team. It can affect your liver and kidneys, and put you and your baby at risk if not managed appropriately.

This is why monitoring is so helpful for catching it early to keep you and your baby safe. Monitoring your blood pressure and urine helps your maternity care team. It lets them know if you need treatment quickly and often allows for more regular monitoring.

How to measure your blood pressure

1. Always measure your blood pressure using the same arm, usually the left arm. Make sure that a health professional has checked that you have the correct sized cuff.
2. You need to fit the cuff onto your bare arm. Wear loose clothing with sleeves that roll up easily, or you can take your arm out of your clothing.
3. Sit on a chair with your back supported. Both feet should be flat on the floor.
4. Rest for 5 minutes before taking readings.
5. Slip the cuff onto your arm so the air tube points towards your wrist.
6. Adjust the bottom edge of the cuff to be about 2cm above your elbow joint.
7. Tighten the cuff around your arm and secure it with the fastening.
8. Rest your arm on a table or across your lap. Your hand should be slightly open with the palm facing upward.
9. Press the start button on the machine and relax.

Readings you should record

Each time you measure your blood pressure, record two readings. The top number is the pressure when your heart beats (systolic pressure, or SYS). The bottom number is the pressure when your heart rests between beats (diastolic pressure, or DIA).

Record both numbers in your blood pressure monitoring diary. If you use an electronic system, enter them there. Some monitors have a third number for pulse (PUL), but you do not need to record this.

Collecting and testing your urine sample

Your maternity care team may ask you to provide a midstream urine sample. This should be passed straight into a clean container.

1. Wipe yourself with a clean tissue to move away any discharge.
2. Start to pass urine into the toilet.
3. Then, put your open container into the stream and collect some urine.
4. Do not touch the inside of the container with your fingers.
5. Once the container is nearly full, take it away.
6. Finish passing urine into the toilet.
7. It is important not to test your first urine of the day.

Reading your urine test result

Your maternity care team will explain how to read the results. You will usually match colour squares on your testing strip with colour results squares on the side of the box.

1. Take a testing strip from the box, being careful not to touch the testing zone.
2. Dip the strip testing zone into your urine sample.
3. Take the strip out and tap off any drips on the side of the container.
4. Hold the strip horizontally (sideways).
5. Wait 60 seconds.
6. Match the colour squares on your testing strip with the results squares on the side of the box.
7. You maternity care team will advise you which boxes in particular to take note of. This is usually protein (PRO), Glucose (GLU) and Leucocytes (LEU)

Understanding the benefits and risks

Monitoring your blood pressure and urine in pregnancy is important. It helps your maternity care team know if you need treatment quickly.

This is especially true if you are at risk of developing pre-eclampsia. Pre-eclampsia can be a complex condition, and dangerous if not treated. It can develop quickly, effecting your liver and kidneys.

Home monitoring offers several benefits, including:

• Convenience
• Feeling more in control and involved in your own care

Balancing benefits with potential risks

It's important to remember that home monitoring is an extra tool to help you. It does not replace advice from your maternity care team.

Reading results the wrong way or becoming overly anxious about readings are potential risks. Your maternity care team will show you how to read and record your results. They will give you that change to practice, and to understand when it is important to get medical advice quickly. This should make home monitoring helpful, not stressful, for you.

Whether you choose to monitor at home or not, your maternity care team will support you. They will answer any questions you have.

How to approach home monitoring safely

Work closely with your maternity care team from the start. This is important to make sure home monitoring is safe and helpful. They will look at your individual needs and decide if home monitoring is right for you.

If it is, they will give you the equipment you need and instructions on how to use it properly. This training will show you the right way to take measurements and how to record your results.

They will also give you clear instructions on when to report your readings and which symptoms mean you should contact them straight away.

Agreeing on a monitoring schedule

Your maternity care team will discuss how often to monitor your blood pressure and urine. In Scotland, some NHS health boards use text messaging services. Services like Florence can send you reminders for your tests.

This will usually be just before your appointments with the maternity team. These appointments may be by video, at a clinic, or over the phone.

If you have a higher chance of developing pre-eclampsia, your team may ask you to monitor more often, or to attend in person.

What to do with your results

Your maternity care team will show you how to read and record results from your home monitors. They will give you a chance to practise.

You will be advised on which reporting systems are used in your area. Equipment will be provided and all of the information you need.

Record your blood pressure and urine test results in your paper diary or the advised electronic system. Do this in the way you have agreed with your maternity care team.

Only report your results at the agreed times. This helps make sure your team sees your results at the right time, as they won't be checking for them outside of these agreed times.

If you ever feel worried about a result you have had at home, you can phone your maternity care team at any time.

In addition to your blood pressure and urinary findings, contact your maternity care team straight away if you have:

• Very swollen ankles.
• Very swollen hands and fingers.
• Very swollen face.
• Headaches that are new, constant or getting worse.
• Blurred vision or see flashing lights and changes to your vision.
• Severe pain in your chest or just below your ribs.

What your maternity care team will do with your results

Your maternity care team will review the results you took at home. They will talk them over with you during your appointment.

They will let you know if you need any medication or further tests. If you already take medication, they will discuss if any changes are needed. They will also let you know if you should go to a clinic or hospital.