Prospective Validation of Usefulness in the Hypertensive Disorder of Pregnancy With Cardiovascular Disease Management Solution Based on Interconnection to Hospital Examination
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 580
- 试验地点
- 2
- 主要终点
- delta SBP
研究概览
简要总结
Objectives: We have developed a cardiovascular disease management application named Heart4U, with the capability of integrating with the Electronic Medical Records (EMR) system within the hospital.
The main goal of this study is to evaluate the clinical effectiveness of a treatment approach that entails self-management of risk factors through a mobile application among pregnant individuals diagnosed with hypertensive cardiovascular conditions.
Methods: Patients assigned to the app group receive assistance from the research team to install the Heart4U application and familiarize themselves with its usage. Both the app group and the usual care group continue to receive active treatment as previously administered (guideline-based prenatal care). Follow-up observations occur at each obstetric examination prior to delivery and are conducted again at the first month postpartum. The primary endpoint of observation pertains to the difference in systolic blood pressure between the enrollment and study completion time points.
详细描述
Inclusion Criteria:
- Diagnosis: 1 or 2
- Pregnant women diagnosed with hypertensive disorders of pregnancy at or beyond 12 weeks of gestation:
- Chronic hypertension: Diagnosed with hypertension within 20 weeks of gestation (elevated office/clinic blood pressure ≥140/90 mm Hg) or currently on antihypertensive medication.
- Gestational hypertension: Newly diagnosed with hypertension after 20 weeks of gestation (elevated office/clinic blood pressure ≥140/90 mm Hg) or currently on antihypertensive medication.
- Preeclampsia: Newly diagnosed with hypertension after 20 weeks of gestation (elevated office/clinic blood pressure ≥140/90 mm Hg) or currently on antihypertensive medication, and presents with proteinuria (300 mg/24 hours or urine protein-to-creatinine ratio ≥0.3), thrombocytopenia (less than 100,000 platelets per microliter), abnormal renal function (creatinine exceeding 1.1 or doubling of baseline), elevated liver enzymes (twice normal levels), neurological symptoms (headache, visual disturbances, seizures, etc.), and/or pulmonary edema.
- Superimposed preeclampsia: Diagnosed with hypertension within 20 weeks of gestation (elevated office/clinic blood pressure ≥140/90 mm Hg) or currently on antihypertensive medication, and experiences symptoms or signs related to superimposed preeclampsia.
- Pregnant women at elevated risk for hypertensive disorders of pregnancy:
Multifetal gestation, obesity, uncontrolled gestational or pre-existing diabetes, history of hypertensive disorder of pregnancy leading to preterm birth, presence of borderline blood pressure readings during antepartum care (elevated office/clinic blood pressure ≥130/80 mm Hg) following a previous diagnosis of hypertension-related disorder in a prior pregnancy.
- Adult individuals aged 18 years and above who possess a smartphone and are capable of independently utilizing the application, among pregnant women.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •Diagnosis: 1 or 2
- •Pregnant women diagnosed with hypertensive disorders of pregnancy at or beyond 12 weeks of gestation:
- •Chronic hypertension: Diagnosed with hypertension within 20 weeks of gestation (elevated office/clinic blood pressure ≥140/90 mm Hg) or currently on antihypertensive medication.
- •Gestational hypertension: Newly diagnosed with hypertension after 20 weeks of gestation (elevated office/clinic blood pressure ≥140/90 mm Hg) or currently on antihypertensive medication.
- •Preeclampsia: Newly diagnosed with hypertension after 20 weeks of gestation (elevated office/clinic blood pressure ≥140/90 mm Hg) or currently on antihypertensive medication, and presents with proteinuria (300 mg/24 hours or urine protein-to-creatinine ratio ≥0.3), thrombocytopenia (less than 100,000 platelets per microliter), abnormal renal function (creatinine exceeding 1.1 or doubling of baseline), elevated liver enzymes (twice normal levels), neurological symptoms (headache, visual disturbances, seizures, etc.), and/or pulmonary edema.
- •Superimposed preeclampsia: Diagnosed with hypertension within 20 weeks of gestation (elevated office/clinic blood pressure ≥140/90 mm Hg) or currently on antihypertensive medication and experiences symptoms or signs related to superimposed preeclampsia.
- •Pregnant women at elevated risk for hypertensive disorders of pregnancy:
- •Multifetal gestation, obesity, uncontrolled gestational or pre-existing diabetes, history of hypertensive disorder of pregnancy leading to preterm birth, presence of borderline blood pressure readings during antepartum care (elevated office/clinic blood pressure ≥130/80 mm Hg) following a previous diagnosis of hypertension-related disorder in a prior pregnancy.
- •Adult individuals aged 18 years and above who possess a smartphone and are capable of independently utilizing the application among pregnant women.
排除标准
- •Patients with evidence of delusions, confusion, or other cognitive disorders.
- •Patients deemed difficult to conduct this study on by the researchers due to various reasons.
- •Cases where device familiarity is significantly low, making data collection challenging.
- •Pregnant patients requiring immediate electronic fetal monitoring or maternal monitoring due to imminent delivery.
结局指标
主要结局
delta SBP
时间窗: between at the time of enrollment and one month postpartum
Systolic Blood pressure (SBP) difference
次要结局
- Blood pressure (systolic, diastolic, mean) trajectory(between at the time of enrollment and one month postpartum)
- Body mass index (kg/m2) trajectory(between at the time of enrollment and one month postpartum)
- obstetric outcomes(between at the time of enrollment and one month postpartum)
- trajectory of the recorded step counts(between at the time of enrollment and one month postpartum)
- Depression evaluation questionnaire(at the time of enrollment and one month postpartum)
研究者
Jung-Won Suh
Professor
Seoul National University Hospital