Expectant mothers who receive remote antenatal care at home is as good as the level of face-to-face consultation, including the identification of common complications, according to a recent study.
The collaborative study run by Monash University and Monash Health delivered an integrated antenatal care program via telehealth between 20 April and 26 July 2020, which successfully reduced face-to-face consultations by 50% without affecting the detection and management of common pregnancy complications, including pre-eclampsia, foetal growth restriction, and gestational diabetes, when compared with conventionally delivered antenatal care.
According to the researchers, the COVID-19 pandemic had seen telehealth become a fundamental component of healthcare. However maternity care presented a unique challenge, with the majority of antenatal appointments usually occurring face-to-face within a hospital environment.
Consequently the trial was developed by a multidisciplinary team of obstetric, midwifery, and general practice providers, telehealth consultations were supplemented with a suite of patient and staff information sheets, and systems to support remote blood pressure checks and foetal growth assessments.
The study’s first author, Dr Kirsten Palmer from the Monash University School of Clinical Sciences and Monash Health said it was clear that antenatal care delivery had to be adapted to protect pregnant women and staff from unnecessary exposure to the virus.
“We recognised that a key limitation of telehealth was the inability to do physical examinations, which are essential in antenatal care, but we were able to implement low-cost measures to support these assessments in the home.”
Blood pressure was self-checked on purchased automated blood pressure monitors, with local health providers, or at the time of hospital ultrasound assessments.
Remote monitoring of foetal growth involved the introduction of self-measured symphyseal-fundal heights weekly from 24 weeks’ gestation plotted on provided foetal growth charts supported by educational material, and ultrasound assessment of foetal growth was done in hospital according to national clinical care recommendations.
“Although telehealth was implemented during a global health crisis, which facilitated the rapid development and uptake of telehealth, this program might provide many benefits for the future delivery of antenatal care and minimise risk in a future epidemic,” Program Director of the Women’s and Newborn Program and Director of Obstetric Services at Monash Health Associate Professor Ryan Hodges said.
“We are hoping to continue it as part of our antenatal care program as it supports women to receive more personalised care with the same excellent outcomes.”
The findings were recently published in The Lancet.