Schramm Katharina, Lapert Florian, Nees Juliane, Lempersz Carlijn, Oei S Guid, Haun Markus W, Maatouk Imad, Bruckner Thomas, Sohn Christof, Schott Sarah
Department of Gynecology and Obstetrics, University Hospital Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany.
Department of Obstetrics and Gynecology, Máxima Medical Center Veldhoven, P.O. box 7777, 5500 MB, Veldhoven, The Netherlands.
Arch Gynecol Obstet. 2018 Dec;298(6):1085-1093. doi: 10.1007/s00404-018-4918-y. Epub 2018 Sep 27.
Reduction of maternal morbidity and mortality is a major worldwide objective anchored in the millennium goals of the United Nations. To improve fetal and maternal care, a constant attempt to discover groundbreaking technologies is ongoing. One approach is the enhancement of non-invasive fetal ECG devices. Most importantly, acceptance of new technologies by pregnant women is a prerequisite for successful implementation.
This questionnaire-based study conducted at the University Hospital Heidelberg, Germany between May and June 2017 evaluates pregnant women's attitudes towards a new device for fetal ECG monitoring and its potential home usage. The study population was questioned after exposure to the Parides/Atlantis prototype (Nemo Healthcare, Veldhoven, The Netherlands), whereas the maternal and gestational age-matched control group was left to envision telemedical topics.
The prototype and its potential usage in a clinical and telemedical setting was highly accepted, and its comfort and appearance satisfied participants. Its use caused significantly improved telemedical understanding as envision increased (p = 0.0015). Implementation and integration of telemedical devices into antenatal care was significantly preferred by the study group (p = 0.0011), though participants desire more specific features for their personal use. Optional home-based self-monitoring to reduce scheduled doctoral visits (p = 0.0004) as well as self-assessment prior to self-initiated, unscheduled consultation (p < 0.0001) could be affected positively by such a device. Furthermore, it could reduce face-to-face interaction with the care provider (p = 0.0163).
The positive feedback on remote self-monitoring might open options for a more "patient as partners" oriented prenatal care in the future. Safety and reliability remain a major issue. More comprehensive studies with new technologies are needed to diligently ensure quality of care. Finally, results for new technologies must be communicated to pregnant women for their acceptance and usage of new devices.
降低孕产妇发病率和死亡率是联合国千年发展目标中的一项主要全球目标。为了改善胎儿和孕产妇护理，人们一直在不断尝试发现突破性技术。一种方法是改进无创胎儿心电图设备。最重要的是，孕妇对新技术的接受是成功实施的先决条件。
这项基于问卷调查的研究于2017年5月至6月在德国海德堡大学医院进行，评估了孕妇对一种新型胎儿心电图监测设备及其潜在家庭使用情况的态度。研究人群在接触Parides/Atlantis原型（荷兰韦尔德霍芬的Nemo Healthcare公司）后接受询问，而年龄和孕周匹配的对照组则被要求设想远程医疗话题。
该原型及其在临床和远程医疗环境中的潜在用途得到了高度认可，其舒适性和外观令参与者满意。随着设想的增加，其使用显著提高了对远程医疗的理解（p = 0.0015）。研究组明显更倾向于将远程医疗设备实施并整合到产前护理中（p = 0.0011），尽管参与者希望其具有更多适合个人使用的特定功能。这样一种设备可能会对减少定期就诊的可选家庭自我监测（p = 0.0004）以及在自行发起的非计划咨询前的自我评估（p < 0.0001）产生积极影响。此外，它可以减少与护理提供者的面对面互动（p = 0.0163）。
对远程自我监测的积极反馈可能为未来更以“患者为伙伴”为导向的产前护理开辟选择。安全性和可靠性仍然是一个主要问题。需要对新技术进行更全面的研究，以切实确保护理质量。最后，必须将新技术的结果传达给孕妇，以便她们接受和使用新设备。
