Background: The burden of hypertensive disorders of pregnancy (HDP) is huge in developing countries. The care during the postpartum period is often overlooked, as delivery is the treatment for HDP that develops during pregnancy.
Methods: This large prospective cohort study was conducted at a tertiary care centre located in the southern part of India. The centre serves pregnant women from 6 districts. All women with HDP who delivered at the centre and have access to teleconsultation were included. 3 teleconsultations were conducted up to 12 weeks postpartum, in addition to selective in-person consultations.
Results: Of the 652 women included, only 242 (37.1%) required antihypertensives at discharge. Overall, 81.9% had attended teleconsultations at 12 weeks, and 8.9% (n=48) required treatment until 12 weeks. Amlodipine (45.9%) and Labetalol (40.1%) were the commonly prescribed antihypertensive medications. Adherence to antihypertensive medications was generally good. Only seven of them required hospitalisation after discharge. Maternal weight, preterm birth, fetal growth restriction, MgSo4 treatment, delivery before 34 weeks and proteinuria were significantly associated with antihypertensive need at discharge. None of the clinical variables was significantly associated with prolonged antihypertensive requirement at 12 weeks. However, nearly 50% (systolic) and 11% (diastolic) of them had blood pressure in the prehypertension range at 12 weeks.
Conclusion: In low-resource countries with reduced manpower, teleconsultation services can be utilised to maintain a continuum of care during the postpartum period in all women with HDP, as none of the clinical variables has been found to be determinants for long-term hypertension.