Is OB HPBM “Evidence-Based”? BUMP1&2 vs SMFM Special Statement

The vast majority of the time, “community standard of care” reflects evidence-based recommendations. This means that both the predominance of clinical data and what is clinically practice align one with another period but at times, clinical standard practice doesn't always align with what the data shows. How is this possible? This is exactly the case for home blood pressure monitoring in pregnancy (HBPM). This episode idea comes from an OB PGY-3, soon PGY-4, who asked his attending this brilliant question: “If the BUMP1 and BUMP2 clinical trials did not show a benefit with HBPM, why are we still doing it?” That is a complicated question that has a solid answer! Unsatisfied with his response, he asked for our opinion. Listen in for details.

1. Tucker KL, et al. (2022). "Effect of self-monitoring of blood pressure on diagnosis of hypertension during higher-risk pregnancy: the BUMP 1 randomized clinical trial. JAMA

2. Chappell LC, et al. (2022). "Effect of self-monitoring of blood pressure on blood pressure control in pregnant individuals with chronic or gestational hypertension: The BUMP 2 Randomized Clinical Trial. JAMA

3. SMFM Special Statement (2023): Society for Maternal-Fetal Medicine Special Statement: Telemedicine in obstetrics—quality and safety considerations; AJOG