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印度北部一家三级护理中心在新冠疫情期间通过远程医疗进行产前护理分诊。

Triage of antenatal care through telehealth during COVID-19 pandemic in a tertiary care centre of North India.

作者信息

Gupta Amrit, Yadav Sangeeta, Seduchidambaram Malathy, Singh Neeta, Pradhan Prasanta K, Pradhan Mandakini

机构信息

Department of Maternal and Reproductive Health, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

Department of Nuclear Medicine and School of Telemedicine and Bioinformatics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

出版信息

J Family Med Prim Care. 2022 Mar;11(3):1055-1058. doi: 10.4103/jfmpc.jfmpc_1155_21. Epub 2022 Mar 10.

Abstract

BACKGROUND

Telemedicine facilitates patient care in various fields including antenatal care. Its application and usefulness need objectification and can be a guide to using this service in the care of pregnant women.

MATERIAL AND METHODS

This was a prospective observational study conducted from May 2020 to December 2020. Following the telemedicine practice guideline of the country, 3,360 teleconsultations were sought by 862 antenatal patients. The duration of each call, an indication of referral and pregnancy risk stratification were noted. Further management was classified into three categories depending upon the need for an immediate hospital visit, no hospital visit or scheduled visit after at least 48 h after the first contact.

RESULTS

The antenatal cases were referred for either maternal, foetal or both indications in 24.7, 54.8 and 20.5% of the cases, respectively. Women were classified as low risk (61.6%), high risk (35.7%) and severe risk (2.7%). In 1.4% of the patients, history and review of the records could not be done through telemedicine. The average time spent was 16.6 min for the first contact and 3.1 min for subsequent contacts. Further management was done with immediate visits in 385 (45.3%), scheduled hospital visits in 292 (34.3%) women and no tertiary care hospital visit in 173 (20.4%).

DISCUSSION

Women (20.4%) not called to the maternal-foetal medicine department of the institute were managed along with the treating obstetrician and no difference in pregnancy outcome was noted.

CONCLUSION

Antenatal care can be provided following triage over teleconsultation and 1.4% of the women may not be able to use telehealth.

摘要

背景

远程医疗有助于包括产前护理在内的各个领域的患者护理。其应用和效用需要客观化,可为在孕妇护理中使用这项服务提供指导。

材料与方法

这是一项于2020年5月至2020年12月进行的前瞻性观察研究。遵循该国的远程医疗实践指南,862名产前患者进行了3360次远程会诊。记录每次通话的时长、转诊指征和妊娠风险分层。根据首次联系后是否需要立即住院就诊、无需住院就诊或至少48小时后安排就诊,将进一步的管理分为三类。

结果

产前病例分别因母体、胎儿或两者指征转诊的比例为24.7%、54.8%和20.5%。女性被分为低风险(61.6%)、高风险(35.7%)和严重风险(2.7%)。1.4%的患者无法通过远程医疗完成病史和记录复查。首次联系的平均时长为16.6分钟,后续联系的平均时长为3.1分钟。进一步的管理包括385名(45.3%)患者立即就诊、292名(34.3%)女性安排住院就诊以及173名(20.4%)患者无需到三级医院就诊。

讨论

未被召唤到该研究所母胎医学科的女性(20.4%)由主治产科医生进行管理,妊娠结局无差异。

结论

通过远程会诊进行分诊后可提供产前护理,1.4%的女性可能无法使用远程医疗服务。

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