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Objective: Clinical evaluation and user experience of the Cloud DX connected HealthKit Pulsewave wrist cuff blood pressure monitor (CDXP) for home blood pressure monitoring during pregnancy.Methods: In the first phase, an adjusted version of the European Society of Hypertension International Protocol Revision 2010 was used to compare the CDXP and Omron M6 Comfort to the gold standard, the aneroid manometer, In the second phase, we evaluated the performance of home blood pressure measurement (HMBPM) by the CDXP to standard hospital blood pressure measurement with the Welch Allyn 53000P. Additionally, patients filled out a questionnaire regarding user experience.Results: In 34 pregnant patients the blood pressure measured by the CDXP did not differ from the aneroid manometer, while the Omron M6 Comfort measured the systolic blood pressure slightly higher (1.5 ± 5.8 mmHg (p = 0.04)) and diastolic blood pressure slightly lower (-2.8 ± 5.8 mmHg (p < 0.01)) as compared to the aneroid manometer. In 32 patients the systolic blood pressure of home blood pressure measurement with the CDXP was significantly lower than the single standard hospital measurements. The mean system usability scaled score was high (85%). Of all patients, 97% reported they liked the idea of home monitoring and would like to use it in the future.Conclusion: The CDXP measured blood pressure correctly, even slightly better than the Omron M6 Comfort and gives a better representation of the blood pressure during the day at home than a single hospital measurement. Pregnant patients are positive about HMBPM and find the CDXP easy to use. [ABSTRACT FROM AUTHOR]

Introduction: An increasing number of women becomes pregnant while suffering from chronic kidney disease (CKD). As a result of decreased renal function, uremic solutes circulate at high levels in the maternal circulation. This study aimed to acquire more knowledge about the placental transfer of uremic solutes across the human placenta.Methods: Placental transfer was studied in healthy term placentas, via the ex vivo dual-side human cotyledon perfusion technique (closed-closed set-up for both maternal and fetal circulations). Uremic solute concentrations in maternal and fetal perfusates were measured via LC-MS/MS over 180 min of perfusion.Results: We found that the studied compounds demonstrated different degrees of placental transfer. Fetal-to-maternal perfusate ratios at t = 180 min were for anthranilic acid 1.00 ± 0.02, indole-3-acetic acid 0.47 ± 0.08, hippuric acid 0.36 ± 0.18, l-arabinitol 0.33 ± 0.04, indoxyl sulfate 0.33 ± 0.11, neopterin 0.28 ± 0.14 and kynurenic acid 0.13 ± 0.03. All uremic solutes studied also emerged in the perfusates when cotyledons were perfused in the absence of uremic solute concentrations added to the maternal reservoir. For kynurenin these concentrations were so high, it complicated the calculation of a transfer ratio for the exogenously administered compound.Discussion: After 180 min of exposure the extent of placental transfer differs substantially for the solutes studied, reflecting different transfer rates. Future studies should investigate to what extent specific uremic solutes reach the fetal circulation in vivo and how they may interfere with organ function and development of the unborn child. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the value of blood pressure measurement by the smartphone device iHealth BP5 in pregnant women in a clinical setting, as compared to the Omron M6 Comfort and aneroid manometer.Materials and Methods: Women with a gestational age of thirty weeks or more who visited the outpatient clinic for routine visit were eligible for inclusion. For the clinical evaluation we used an adjusted form of the European Society of Hypertension International Protocol. We performed six blood pressure measurements per patient, divided over the iHealth BP5, Omron M6 Comfort and aneroid monitor. Statistical analysis consisted of repeated measurement ANOVA and Bland-Altman plots.Results: We included 45 women. The mean blood pressure differences between all tested devices were less than ±5 mmHg. These differences did not relate to gestational age, BMI or arm circumference. Bland-Altman plots showed good agreement of both iHealth BP5 and Omron M6 Comfort, without any systematic effects, as compared to the aneroid manometer.Conclusion: The iHealth BP5 is as good as the frequently used Omron M6 Comfort and can be used for blood pressure measurement during pregnancy.Condensed Abstract: In 45 women the mean blood pressure differences between the Omron M6 Comfort, iHealth BP5 and the aneroid manometer were less dan ±5 mmHg. These differences did not relate to gestational age, BMI or arm circumference. Bland-Altman plots showed good agreement of both iHealth BP5 and Omron M6 Comfort, without any systematic effects, as compared to the aneroid manometer. The iHealth BP5 is as good as the frequently used Omron M6 Comfort and can be used for blood pressure measurement during pregnancy. [ABSTRACT FROM AUTHOR]