Management of Hypertension in Pregnancy: Policy Options for Health Care Service Decision-Makers

Introduction: Hypertensive disorders are a major cause of maternal mortality, and early detection can reduce risks for mothers and infants. Implementing evidence based, context appropriate strategies may improve outcomes. This study aimed to propose policy options to strengthen monitoring and management of hypertension in pregnancy. Methods: The study consisted of two phases. First, a scoping review synthesized global strategies for improving hypertension management during pregnancy. Searches were conducted in PubMed, Web of Science, Scopus, Cochrane Library, SID, and Google Scholar without time limits, restricted to English and Persian studies. Based on the findings, policy options were developed. In the second phase, 13 experts evaluated these options across five criteria—population benefit, cost/economics, ethics/equity, feasibility, and constituency acceptance—using a five point Likert scale. The top options were further analyzed for advantages, disadvantages, and implementation needs. Results: From 2,253 identified records, 14 studies informed five policy options: (a) an educational video package on hypertension and preventive self‑care; (b) a maternal mobile application for hypertension management; (c) remote self‑monitoring of blood pressure; (d) a smart multimodal management system; and (e) ambulatory monitoring with Holter devices. Experts ranked the educational video package highest overall and highest for cost/economic, ethics/equity, and feasibility, the mobile application highest for constituency acceptance, and remote blood pressure monitoring highest for population benefit. Conclusion: Integrating global evidence with expert input yielded three priority policy options: educational video‑based training, a maternal hypertension management app, and remote self‑monitoring of blood pressure. These strategies emphasize empowerment and improved self‑management for pregnant women.