Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat Gan, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel.
Int J Gynaecol Obstet. 2024 Feb;164(2):662-667. doi: 10.1002/ijgo.15018. Epub 2023 Aug 8.
To determine the feasibility of extending remote maternal-fetal care to include fetus well-being.
The authors performed a prospective pilot study investigating low-risk pregnant participants who were recruited at the time of their first full-term in-person visit and scheduled for a follow-up telemedicine visit. Using novel self-operated fetal monitoring and ultrasound devices, fetal heart monitoring and amniotic fluid volume measurements were obtained to complete a modified biophysical profile (mBPP). Total visit length was measured for both the in-person first visit and the subsequent telemedicine encounter. A patient satisfaction survey form was obtained.
Ten women between 40 + 1 and 40 + 6 weeks of gestation participated in telemedicine encounters. Nine women (90%) were able to complete remote mBPP assessment. For one participant, fetal assessment was not completed due to technically inconclusive fetal monitoring. Another participant was referred for additional assessment in the delivery room. Satisfactory amniotic fluid volume measurements were achieved in 100% of participants. The telemedicine encounter was significantly shorter (93.1 ± 33.1 min) than the in-person visit (247.2 ± 104.7 min; P < 0.001). We observed high patient satisfaction.
Remote fetal well-being assessment is feasible and time-saving and results in high patient satisfaction. This novel paradigm of comprehensive remote maternal and fetal assessment is associated with important clinical, socioeconomic, and logistics advantages.
确定将远程母婴保健扩展至包括胎儿健康状况的可行性。
作者进行了一项前瞻性试点研究,调查了招募于首次全面门诊就诊时且计划进行后续远程医疗就诊的低风险孕妇参与者。使用新型自主操作的胎儿监测和超声设备,获取胎儿心率监测和羊水量测量值,以完成改良生物物理评分(mBPP)。测量了面对面首诊和随后的远程医疗就诊的总就诊时间。获得了患者满意度调查表格。
10 名 40+1 至 40+6 孕周的孕妇参加了远程医疗就诊。9 名女性(90%)能够完成远程 mBPP 评估。对于 1 名参与者,由于胎儿监测技术上不确定,胎儿评估未完成。另 1 名参与者被转介到产房进行进一步评估。100%的参与者均实现了满意的羊水量测量。远程医疗就诊时间明显短于面对面就诊(93.1±33.1 分钟 vs. 247.2±104.7 分钟;P<0.001)。我们观察到了较高的患者满意度。
远程胎儿健康状况评估是可行且节省时间的,并且患者满意度高。这种综合远程母婴评估的新颖模式具有重要的临床、社会经济和后勤优势。