1 Globally, around 15% of maternal mortality is due to pre-eclampsia so early detection and prevention are paramount. Raised blood pressure (BP) affects approximately 10% of pregnancies worldwide, almost half of these women develop pre-eclampsia. A linked process evaluation will combine quantitative and qualitative data to examine how BP self-monitoring in pregnancy is implemented and accepted in both daily life and routine clinical practice. An economic evaluation of BP self-monitoring in addition to usual care compared with usual care alone will be assessed across both study populations within trial and with modelling to estimate long-term cost-effectiveness. Other outcomes will include maternal and perinatal outcomes, quality of life and adverse events. The BUMP 2 primary outcome is mean systolic BP between baseline and delivery recorded by healthcare professionals.

The BUMP 1 primary outcome is the time to the first recording of raised BP by a healthcare professional. BUMP 1 will recruit a minimum of 2262 pregnant women at higher risk of pregnancy hypertension and BUMP 2 will recruit a minimum of 512 pregnant women with either gestational or chronic hypertension. Participants will be randomised to self-monitoring with telemonitoring or usual care. Methods and analyses Both are multicentre, non-masked, parallel group, randomised controlled trials. Correspondence to Professor Lucy Chappell .uk.11 School of Psychological Science, University of Bristol, Bristol, UK.10 Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK.9 Department of Women and Children's Health, Kings College, London, London, UK.8 NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.7 Centre for Maternal & Child Health Research, School of Health Sciences, City University, London, UK.

6 Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, University of Oxford, Oxford, UK.5 Primary Care Clinical Sciences, Institute of Applied Health Research, University of Birmingham, Birmingham, UK.3 Academic Unit of Psychology, University of Southampton, Southampton, UK.2 National Perinatal Epidemiology Unit (NPEU), Nuffield Department of Population Health, University of Oxford, Oxford, UK.1 Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.

Blood pressure chart for pregnant