Early Detection and Management for Postpartum Pre-eclampsia

(PREDiCT-NPL Trial)

This trial aims to find better ways to detect and manage preeclampsia, a condition with high blood pressure that occurs after childbirth. Researchers will test whether certain blood markers can predict who is at risk and then explore different care strategies for high-risk patients. Individuals who have had preeclampsia before or have conditions like diabetes or kidney disease, and plan to deliver at Dhulikhel Hospital, might be suitable for this study.

As an unphased study, this trial offers a unique opportunity to contribute to groundbreaking research that could enhance care for future mothers.

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

Research has shown that checking blood pressure from home after childbirth is safe and effective. Studies suggest that using technology for blood pressure monitoring helps detect problems early and can be as reliable as traditional follow-up visits. For example, both patients and doctors can notice changes in blood pressure more quickly, allowing for faster treatment of any issues.

The treatment plan includes nifedipine ER, a common medication used to control high blood pressure. Many patients tolerate this medication well, and it is often used safely for other high blood pressure-related conditions.

Researchers are excited about this trial because it focuses on early detection and management of postpartum pre-eclampsia, a condition that can be challenging to manage after childbirth. Unlike standard care, which often involves monitoring and treating symptoms as they arise, this approach uses a proactive strategy by identifying high-risk individuals through the sFlt-1/PlGF ratio. This allows for early intervention with remote blood pressure monitoring and education, alongside the administration of nifedipine ER for outpatient care. The trial aims to prevent complications by managing mild hypertension before symptoms become severe, potentially improving outcomes for new mothers.

This trial will compare different approaches for managing postpartum preeclampsia. Research has shown that checking blood pressure at home after giving birth is a reliable and effective way to manage high blood pressure. Participants in the "High-risk Intervention" arm will receive early detection and management of postpartum preeclampsia through remote blood pressure monitoring, education, and antihypertensive medication (nifedipine ER) for outpatient management of asymptomatic, mild-range blood pressure. Studies have found that home blood pressure monitoring can help catch problems early and improve care. This is especially important for women who had high blood pressure during pregnancy, as it helps identify issues that might continue or worsen after delivery. Additionally, taking blood pressure medication, like nifedipine ER, is part of treating mild high blood pressure and has been proven to help manage blood pressure levels. This approach aims to catch and manage postpartum preeclampsia early, potentially reducing serious health risks.¹⁶⁷⁸⁹