Mobile Health Solutions for Hypertensive Disorders in Pregnancy: Scoping Literature Review.
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BACKGROUND Hypertensive disorders are the most common complications during pregnancy occurring in 5 to 11 of pregnancies gestational hypertension and preeclampsia are the leading causes of perinatal and maternal morbidity and mortality especially in low and middle income countries LMIC where maternal and perinatal mortality ratios are still high Pregnant women with hypertensive disorders could greatly benefit from mobile health mHealth solutions as a novel way to identify and control early symptoms as shown in an increasing number of publications in the field Such digital health solutions may overcome access limiting factors and the lack of skilled medical professionals and finances commonly presented in resource poor environments OBJECTIVE The aim of this study was to conduct a literature review of mHealth solutions used as support in hypertensive disorders during pregnancy with the objective to identify the most relevant protocols and prototypes that could influence and improve current clinical practice METHODS A methodological review following a scoping methodology was conducted Manuscripts published in research journals reporting technical information of mHealth solutions for hypertensive disorders in pregnancy were included categorizing articles in different groups Diagnosis and Monitoring mHealth Decision Support System Education and Health Promotion and seven research questions were posed to study the manuscripts RESULTS The search in electronic research databases yielded 327 articles After removing duplicates 230 articles were selected for screening Finally 11 articles met the inclusion criteria and data were extracted from them Very positive results in the improvement of maternal health and acceptability of solutions were found although most of the studies involved a small number of participants and none were complete clinical studies Accordingly none of the reported prototypes were integrated in the different health care systems Only 4 studies used sensors for physiological measurements and only 2 used blood pressure sensors despite the importance of this physiological parameter in the control of hypertension The reported mHealth solutions have great potential to improve clinical practice in areas lacking skilled medical professionals or with a low health care budget of special relevance in LMIC although again no extensive clinical validation has been carried out in these environments CONCLUSIONS mHealth solutions hold enormous potential to support hypertensive disorders during pregnancy and improve current clinical practice Although very positive results have been reported in terms of usability and the improvement of maternal health rigorous complete clinical trials are still necessary to support integration in health care systems There is a clear need for simple mHealth solutions specifically developed for resource poor environments that meet the United Nations Sustainable Development Goal SDG of enormous interest in LMIC