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Pregnancy can be both an exciting and an anxious time. Regular check-ups and communication with healthcare providers are important for monitoring the health of both mother and baby.
Telemedicine use during pregnancy increased during the COVID-19 pandemic, in order to reduce the risk of viral transmission.
Apart from the need to reduce physical contacts during a pandemic, is telemedicine a useful method of healthcare delivery for pregnant and new mothers? How can we ensure that telemedicine is used safely to promote optimal outcomes?
What benefits can telemedicine provide during pregnancy?
When used in the right way, alongside in-person care, telemedicine applications can provide many benefits.
● Telemedicine gives patients the ability to access care at a convenient time and location, fitting around their work and care-giving responsibilities.
● Remote consultations provide easier access to specialist care. This is especially beneficial for those living in rural or underserved areas where there is less access to specialist care.
● Online portals and mobile apps help to improve communication with healthcare providers and provide easy access to reliable information and advice.
● Telemedicine can also provide reassurance for expectant mothers and families, with the ability for healthcare providers to advise when an in-person visit is required.
Which maternal health services can be delivered via telemedicine?
With the right telecommunications and monitoring equipment and support, many maternal health services can be provided remotely, either from home or a local primary care clinic, including:
● Routine antenatal appointments
● Remote monitoring for weight, blood pressure, blood glucose, foetal heart rate etc.
● Specialist review of ultrasound imaging conducted by a local ultrasound technician
● Consultation with specialists
● Review of test results
● Mental health care
● Prescription management
● Postpartum visits
● Lactation support
What equipment is required?
As well as a connected device with a camera and reliable internet connection, the following prenatal monitoring equipment can be used:
● Blood pressure monitor
● Portable foetal heart rate monitor
● Pulse oximeter
● Blood glucose testing equipment
● Weight scale
● Tape measure
Can telemedicine improve care during pregnancy?
The goal of maternal care is to promote the health of both mother and baby by providing high quality care and support during pregnancy, delivery and postnatally. The World Health Organization recommends a minimum of 8 contacts during a 40 week pregnancy, more where specific risk factors are identified. Country guidelines vary, with some recommending 12 to 14 prenatal care visits, even for low risk pregnancies. Some visits, such as those requiring an internal examination or ultrasound, must be conducted in-person. However, especially for low-risk pregnancies, telemedicine can be safely used to reduce the number of in-person visits required.
The Mayo Clinic evaluated the efficacy of a pregnancy care model that utilised telemedicine to convert 40% to 50% of appointments to home for patients with low-risk pregnancies. This included self-monitoring (weight, fundal height, blood pressure, foetal heart rate), text-based communication between care team and patient, and an online community. They found that this model increased patient satisfaction, patient engagement and continuity of care while maintaining care standards and reducing costs, compared to the traditional model of care.
Can telemedicine be used for high risk pregnancies?
High risk pregnancies are those with an increased likelihood of complications due to risk factors such as high blood pressure (causing preeclampsia), multiple births, gestational diabetes, known foetal abnormalities, or an age over 40. While high-risk pregnancies will require a greater number of in-person visits, telemedicine can still be used for at-home monitoring, such as for high blood pressure and diabetes. A review of 7 randomised controlled trials comparing the use of telemedicine for blood sugar monitoring during pregnancy with standard care, found it was as effective in achieving glucose control.
Care must of course be taken to ensure that any complications are detected early and dealt with promptly. Patients and their families should also know who to contact in an emergency or if they have any concerns.
Guidelines for telemedicine pregnancy care
● Patients may require support to use the required technology correctly.
● Clear instructions should be given and informed consent obtained, prior to a virtual appointment.
● Flexibility may be required with communication methods, especially where there is not a reliable and stable internet connection.
● Electronic health records (EHR) should be read before appointments and kept up to date.
The safe and effective use of telemedicine requires both patients and staff to be well-informed and educated so that signs indicating the need for an urgent in-person visit can be recognised and acted on. These may include decreased foetal movement, preeclampsia symptoms or signs of early labour.
What about postpartum care?
Telemedicine can offer many benefits after a baby is born, to address the physical, emotional and social wellbeing of parents and babies. In-person visits are required for checking surgical incision sites, hands on lactation support and vaccinations. However, many aspects of postpartum care can be delivered via telemedicine such as general health check-ups, advice and support, screening and treatment for postpartum depression. A systematic review of studies investigating the effectiveness of telemedicine for postpartum depression found a significantly greater improvement in depression scores, higher completion rates, and higher satisfaction scores compared to traditional care. Telemedicine can enable new parents to access timely care conveniently from home.
In summary
Telemedicine can offer many benefits for both prenatal and postnatal care. To make the best use of telemedicine, healthcare providers, patients and families should receive the correct training and support, and know when in-person care is required.
Are you looking for the ideal telemedicine software for your practice?
Medoment is a complete engagement solution that securely and seamlessly integrates all aspects of the care pathway, with teleconsultations, remote patient monitoring and a patient engagement portal within a single platform.
To find out more, or book a demonstration, contact us today:
https://htworkslk.com/Medoment/
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