Medani Isameldin Elamin, Hakami Ahlam Mohammed, Chourasia Uma Hemant, Rahamtalla Babiker, Adawi Naser Mohsen, Fadailu Marwa, Salih Abeer, Abdelmola Amani, Hashim Khalid Nasralla, Dawelbait Azza Mohamed, Yousf Noha Mustafa, Hassan Nazik Mubarak, Ali Nesreen Alrashid, Rizig Asma Ali
Department of Obstetrics and Gynecology, Faculty of Medicine, Jazan University, Jazan 82722, Saudi Arabia.
Department of Community Medicine, University of Medical Sciences and Technology, Khartoum 12810, Sudan.
Healthcare (Basel). 2025 Aug 18;13(16):2036. doi: 10.3390/healthcare13162036.
Telemedicine has transformed obstetrics and gynecology (OB/GYN), accelerated by the COVID-19 pandemic. This study aims to synthesize evidence on the adoption, effectiveness, barriers, and technological innovations of telemedicine in OB/GYN across diverse healthcare settings. This scoping review synthesized 63 peer-reviewed studies (2010-2023) using PRISMA-ScR guidelines to map global applications, outcomes, and challenges. Key modalities included synchronous consultations, remote monitoring, AI-assisted triage, tele-supervision, and asynchronous communication. Results demonstrated improved access to routine care and mental health support, with outcomes for low-risk pregnancies comparable to in-person services. Adoption surged >500% during pandemic peaks, stabilizing at 9-12% of services in high-income countries. However, significant disparities persisted: 43% of rural Sub-Saharan clinics lacked stable internet, while socioeconomic, linguistic, and cultural barriers disproportionately affected vulnerable populations (e.g., non-English-speaking, transgender, and refugee patients). Providers reported utility but also screen fatigue (41-68%) and diagnostic uncertainty. Critical barriers included fragmented policies, reimbursement variability, data privacy concerns, and limited evidence from conflict-affected regions. Sustainable integration requires equity-centered design, robust policy frameworks, rigorous longitudinal evaluation, and ethically validated AI to address clinical complexity and systemic gaps.
远程医疗在新冠疫情的推动下改变了妇产科领域。本研究旨在综合不同医疗环境下远程医疗在妇产科应用、有效性、障碍及技术创新方面的证据。这项范围综述使用PRISMA-ScR指南综合了63项同行评审研究(2010 - 2023年),以梳理全球应用情况、结果及挑战。主要模式包括同步会诊、远程监测、人工智能辅助分诊、远程监督和异步通信。结果表明,常规护理和心理健康支持的可及性得到改善,低风险妊娠的结果与面对面服务相当。在疫情高峰期,采用率激增超过500%,在高收入国家稳定在服务的9% - 12%。然而,显著差异依然存在:撒哈拉以南农村地区43%的诊所缺乏稳定的互联网,而社会经济、语言和文化障碍对弱势群体(如非英语使用者、跨性别者和难民患者)的影响尤为严重。提供者报告了其效用,但也存在屏幕疲劳(41% - 68%)和诊断不确定性。关键障碍包括政策碎片化、报销差异、数据隐私问题以及受冲突影响地区的证据有限。可持续整合需要以公平为中心的设计、强大的政策框架、严格的纵向评估以及经过伦理验证的人工智能,以应对临床复杂性和系统性差距。