Monitoring blood pressure and urine during pregnancy

If you have both high blood pressure and protein in your urine, it can mean you are at risk of developing a condition called pre-eclampsia.

This can be a serious condition affecting your liver and kidneys, possibly leading to a seizure or stroke in severe cases.

Some pregnant women have a higher chance of developing pre-eclampsia.

It's important for you and your baby’s health to monitor your blood pressure and urine in pregnancy.

It helps your maternity care team know if you need treatment and make sure you get it quickly.

More about pre-eclampsia

Monitoring blood pressure and urine at home

Self-monitoring of blood pressure and urine at home is safe when it is part of continuous assessment with your maternity care team, even for women with a higher chance of developing pre-eclampsia.

Your maternity care team will help you decide whether monitoring at home feels right for you and your baby. They will:

  • give you equipment to use at home
  • explain why monitoring is important for you and your baby
  • show you how to do the tests
  • explain what your results might show and the levels which are safe for you
  • explain what to do if you feel unwell

Whether you choose to monitor at home or not, your maternity care team will be there to support you and answer any questions you may have.

How often blood pressure and urine should be monitored

Your maternity care team will discuss how often to monitor your blood pressure and urine with you.

In Scotland some NHS health boards use text messaging, such as the Florence service, to send you a reminder when it’s time to do your tests.

This will usually be just before your pregnancy care appointments, which may be:

  • by video appointment, using a system called NHS Near Me
  • at a clinic or hospital
  • over the phone

If you have a higher chance of developing pre-eclampsia, you may be asked to monitor more often.

What you do with your results

Your maternity care team will show you how to read and record results from your home monitors and give you an opportunity to practice doing this.

They will tell you which reporting systems are used in your area and help you get the equipment and information you need.

Find more about home blood pressure monitoring and using Florence

Find out more about BadgerNet Maternity

Reporting results

Record your blood pressure and urine test results in your self-monitoring paper diary or electronic system in the way you’ve agreed with your maternity care team.

Only report your results at the agreed times, as your maternity care team won’t know to check for them at other times.

If you ever feel worried about a result you’ve had at home, you can phone your maternity care team at any time.

At any time if you are feeling very unwell with severe headache, stomach pain and/or changes to vision including flashing light please contact the maternity care team immediately.

What your maternity care team will do with your results

Your maternity care team will review the results you took at home and talk them over with you during your appointment.

They’ll advise if you need any medication or further tests to keep you and your baby safe.

If you already take medication, they’ll advise if changes are needed or if you should go to a clinic or hospital.

What happens to your information?

Your information, including your results from home monitoring, will be kept private in your own maternity records.

It will only be shared with the staff involved in your care.

Information is sometimes called ‘data’ and you may be asked to give permission for your data to be used for evaluation.

This means your data could be used to check how home monitoring is working for women and families.

Data which is identifiable to you will never be used without your consent.

Learn more about your health rights and responsibilities

Collecting and testing your urine sample

You will be asked to provide a ‘midstream specimen’ of urine which should be passed straight into a clean container. 

Follow these instructions to collect and test your urine sample:

  1. Start to pass urine into the toilet then put your open container into the stream and collect some urine.
  2. Do not touch the inside of the container with your fingers.
  3. Once the container is nearly full, take it away and finish passing urine into the toilet.

It is important that you do not test your first urine of the day.

Reading your result

Your maternity care team will explain how to read the results. Usually, you will be asked to match colour squares on your testing strip with colour results squares on the side of the box.

To read the result: 

  1. Take a testing strip from the box, taking care not to touch the ‘testing zone’.
  2. Dip the strip ‘testing zone’ into your urine sample
  3. Take the strip out of your sample and tap off any drips on the side of the container
  4. Hold the strip horizontally (sideways)
  5. Wait 60 seconds.
  6. Match the colour squares on your testing strip with the results squares on the side of the box.

You need one result for protein (PRO) and one result for glucose (GLU) in your urine.

Your maternity care team will also explain:

  • what your results might show
  • the levels which are ‘normal’ for you
  • what to do if you're worried about your results or you feel unwell

If you're worried about your results, keep the testing strip and your sample so you can give them to your maternity care team if you are advised to go to a clinic or hospital.

Urgent advice: Contact your maternity care team immediately if you find:

  • 1+ or more of protein when your urine was previously negative
  • 2+ or more of protein when your urine was previously 1+
  • 2+ or more of glucose in your urine
  • 1+ of glucose more than once

If you need to go into hospital for maternity admissions or labour ward take your blood pressure monitor and the sample of urine with you with you.

How to measure your blood pressure

Always measure your blood pressure using the same arm (normally the left arm).

You need to be able to fit the cuff onto your bare arm.

To make sure the cuff is on properly:

  1. Wear loose clothing with sleeves that roll up easily and don't feel tight when rolled up. Or you could take your arm out of your clothing.
  2. Sit on a chair with your back supported and both feet flat on the floor. Rest for 5 minutes before beginning to take blood pressure readings.
  3. Slip the cuff onto your arm so that the air tube points towards your wrist. The yellow line on the cuff should be over the inside of your elbow.
  4. Adjust the bottom edge of the cuff so it's about 2cm above the inside of your elbow joint.
  5. Tighten the cuff around the arm and secure it using the Velcro then rest your arm on a table or across your lap with your hand slightly open and the palm facing upward.

You're now ready to take a reading:

  1. Press the start button on the front of the machine 
  2. Relax. Don't talk or move your arm muscles until the measurement is completed
  3. Measure your blood pressure twice, with the measurements at least one minute apart

(https://www.youtube.com/watch?v=GSNZVaW1Wg4)

British Heart Foundation has a useful video about how to take your blood pressure.

Readings you should record

Each time you measure your blood pressure you need to record two readings:

  • the top number is called SYS, short for systolic
  • the bottom number is called DIA, short for diastolic

Record both numbers in your blood pressure monitoring diary. Enter them, if you are using an electronic system.

Some monitors have a third number called ‘PUL’. This is for pulse. You don’t need to record the ‘PUL’ number.

What the results mean

Your maternity care team will help you understand the blood pressure levels which are ‘normal’ for you.

They will give you a note of the blood pressure ranges which are normal for you and the levels which would be high for you.

High results may mean you need to go to your clinic or hospital.

Urgent advice: Contact your maternity care team straight away if you have:

  • very swollen ankles, fingers, hands or face
  • headaches (new or getting worse)
  • blurred vision or see flashing lights and changes to your vision
  • severe pain in your chest or just below your ribs

If you need to go into hospital for maternity admissions or labour ward take your blood pressure monitor and the sample of urine with you with you.