When Amanda Sanderson learned she was expecting her first child in 2013, she never expected to experience hypertension in pregnancy (also known as preeclampsia). As a nurse at UPMC Children’s Community Pediatrics who formerly worked at the UPMC Magee-Womens Hospital neonatal intensive care unit (NICU), she interacted with new mothers and babies with the condition on a consistent basis.
“I was young and I was healthy, which are all things that would make you think you’d have an easy-breezy pregnancy,” Amanda said. “I definitely didn’t have any huge risk factors for it, and I never thought that I would really develop it or go on to have any pregnancy-complications due to it.”
However, Amanda has experienced preeclampsia – a hypertensive disorder characterized by high blood pressure during or after pregnancy – during all three of her pregnancies. But it wasn’t until her most recent pregnancy in 2020 when her obstetrician referred her to the UPMC Postpartum Hypertension Program, comprised of a team of experts that specifically treat high blood pressure issues in new or expectant mothers.
The Problem: Preeclampsia
Preeclampsia is a very common condition in the United States, affecting one in 12 new mothers. It often goes undetected anmyd unrecognized, which can lead to emergency events like heart attack and stroke. Left untreated, it can also lead to heart failure and more serious conditions like eclampsia, a rare but deadly disease that causes seizures.
“When I worked in NICUs at UPMC, hypertensive disorders like preeclampsia were one of the most common reasons new babies were admitted to the unit,” Amanda said. “After my first baby, I had a whole new perspective of what women went through who had the diagnosis.”
In general, many people are unaware that they have high blood pressure because it often doesn’t present any symptoms. However, hypertensive disorders are silent killers, as any blood pressure reading higher than 130 mmHg over 80 mmHg can lead to heart disease, which is the leading cause of death in women and men in the United States.
“My first feeling when I was diagnosed with it was definitely fear,” Amanda said. “Knowing the little bit of information I knew from work – that preeclampsia can lead you to deliver early, or your baby can be small and you can have complications afterwards – that was all pretty scary.”
The Path to the Postpartum Hypertension Program
Despite suffering from preeclampsia during her first two pregnancies, Amanda recalls feeling disconnected from her health care providers. When her obstetrician enrolled her in the UPMC Postpartum Hypertension Program, she explained that a team of nurses and doctors from the Division of Maternal Fetal Medicine and the Heart and Vascular Institute would keep track of her blood pressure and periodically check in on her until it came down.
“Being a new patient at the UPMC Postpartum Hypertension Program, this was a level of care I had not experienced with my other two pregnancies,” Amanda said.
As part of the program, Amanda was able to record her blood pressure readings in the comfort of her home. Experts at the Postpartum Hypertension Program offer remote monitoring health care, in which patients record vitals using equipment provided by the Magee-Womens Hospital and their own smart technology.
Every day, Amanda took her blood pressure and answered a few questions related to how she was feeling, and then input the data into an app called Vivify Health®. For the first 6 weeks postpartum, a team of nurses and doctors monitor the readings virtually 24/7 and follow up with patients if anything isn’t normal. After 6 weeks, patients are monitoring twice a week.
“For the first six weeks after delivery, I got a text message every single day from the program,” Amanda said. “The first day I pressed that I wasn’t feeling great, somebody called me within five minutes. And I think it was on a Sunday actually.”
When her blood pressure wasn’t going down within the time doctors had hoped, Amanda was prescribed a new medication without even having to go to the doctor’s office.
The Results: Taking Control of Her Health Care
Thanks to the UPMC Postpartum Hypertension Program, remote monitoring, and telemedicine, Amanda was able to recover from her preeclampsia at home with her family. Amanda remembers how cumbersome it can be to get from appointment to appointment while taking care of a newborn. And of course, the COVID-19 pandemic added another layer of fear to the already difficult process.
Overall, the UPMC Postpartum Hypertension Program made Amanda feel more in control of her health care, in addition to feeling like somebody cared about her wellbeing.
“The program made me feel good after a time frame of feeling so out of control with all the complications and all the stress that comes with preeclampsia,” Amanda said. “This was definitely empowering.”
Amanda's treatment and results may not be representative of similar cases.