Antenatal management of at‐risk pregnancies from a distance

Ivey, Tesa; Hughes, Dawn S.; Dajani, Nafisa K.; Magann, Everett F.

doi:10.1111/ajo.12254

Cited by 19 publications

(20 citation statements)

References 8 publications

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“…This is higher than the study done by Ivy et al where 27.5% referrals were done and in study by Lund et al where 10% of referrals were done in interventional group and 5% in control group. 17,16 In the present study, 101 women out of 102 in study group (one woman aborted at 12 weeks) and 102 in control group had institutional deliveries which were high when compared to study done by Battle et al where 75% delivered at a facility and 78% delivered under skilled care. 18 In our study, a significant difference was noted in Hb% in last visit in study group [p-0.004] when compared to a study done by Khorshid et al where no effect on anaemia was found, as there were no significant differences in hemoglobin and hematocrit in study group.…”

Section: Discussioncontrasting

confidence: 55%

The role of m-health in providing antenatal care in rural areas

Menaka¹,

Kamineni²,

Sree³

2017

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONGlobally about 800 women die every day of preventable causes related to pregnancy and childbirth and 20 % of such deaths are from India. It is estimated that per year, 55,000 women die due to preventable pregnancy-related causes in India.1 The United Nations' Millennium Development Goal (MDG5) was to reduce maternal mortality rate (MMR) by 75% between 1990 and 2015. 2 In order to achieve these goals and accelerate their progress, newer strategies like m-Health are required. India faces several challenges in meeting the needs of pregnant women, particularly those related to complications of pregnancy and obstetric emergencies. Besides medical causes, other factors that may contribute to maternal deaths are delay in care-seeking due to delay in identifying the complication, deciding to seek care, transportation to a health facility, and delay in receiving appropriate treatment.3 Mobile health (m-Health) denotes using small portable and wireless communication devices like mobile phones, personal digital assistants, based on web applications to facilitate the health needs of health care providers and consumers. The basic idea of m-health application for expectant mothers is that community health workers collect data about pregnant women and send to a specialist. The specialist views the patient information and provides feedback to the mobile of community health worker.4 It works as a good support system and is operated by rural health workers to improve point of care diagnostic support. It is also useful for screening of patients who need specialist care and to provide advice for routine cases. ABSTRACT Background:The maternal mortality rate is high in India and many deaths are due to preventable causes related to pregnancy. Mobile-health is an innovative strategy wherein, mobile phones are used for pregnancy tracking and giving support during the antenatal period. Aims and objectives of the study was to know the role of m-Health in providing antenatal care in rural areas. Methods: This was a prospective, comparative study carried out at Kamineni Hospital, LB Nagar, Hyderabad and the Primary Health Centres (PHC) of Uppal and Narapally, Ranga Reddy district over a period of one year nine months and consisted of 204 registered antenatal cases divided into study and control groups. Both groups received routine antenatal support and the study group, in addition received mobile health support also. Various parameters were compared in both the groups. Results: The study group had more antenatal visits, better correction of anemia, less number of patients who were lost to follow-up, and more number of Caesarean deliveries. Conclusions: Mobile health helps in pregnancy tracking and increasing the antenatal visits. It helps in timely referrals for high-risk pregnancies in remote areas and it has the potential to provide obstetric care and consultations to both low risk and at-risk women in rural areas where specialist care is not always available.

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Section: Discussioncontrasting

confidence: 55%

The role of m-health in providing antenatal care in rural areas

Menaka¹,

Kamineni²,

Sree³

2017

Int J Reprod Contracept Obstet Gynecol

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“…However, the question remains as to whether Internet-based interventions may offer cost-effective service compared to usual care [28]. Interventions delivered over the Internet are likely to cost less than face-to-face services requiring frequent contact with health care personnel, and their relatively low delivery cost could result in an Internet-based intervention being more cost effective [4,26].…”

Section: Discussionmentioning

confidence: 99%

“…Four reviews focused on the use of technologies to evaluate healthy pregnant women in terms of maternal outcomes [27], women with complicated pregnancies in terms of cost effectiveness [28], a mixed group of patients (with type 1 DM and GDM) in terms of maternal-neonatal outcomes [29], and patients with GDM in terms of maternal outcomes [30]. These studies reported mixed results, did not include ongoing studies without outcomes [27], lacked systematic searching strategies [28,29], and evaluated limited studies (n=3) [30]. None of the studies focused on Internet-based self-monitoring approaches.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Internet-Based Self-Monitoring Interventions on Maternal and Neonatal Outcomes in Perinatal Diabetic Women: A Systematic Review and Meta-Analysis

Lau¹,

Htun²,

Wong³

et al. 2016

J Med Internet Res

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BackgroundSelf-monitoring using the Internet offers new opportunities to engage perinatal diabetic women in self-management to reduce maternal and neonatal complications.ObjectiveThis review aims to synthesize the best available evidence to evaluate the efficacy of Internet-based self-monitoring interventions in improving maternal and neonatal outcomes among perinatal diabetic women.MethodsThe review was conducted using Cochrane Central Register of Controlled Trials, PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature, PsyINFO, Scopus, and ProQuest Dissertations and Theses to search for English-language research studies without any year limitation. A risk of bias table was used to assess methodological quality. Meta-analysis was performed with RevMan software. Cochran Q and I2 tests were used to assess heterogeneity. The overall effect was assessed using z tests at P<.05. Of the 438 studies identified through electronic searches and reference lists, nine experimental studies from 10 publications were selected.ResultsHalf of the selected studies showed low risk of bias and comprised 852 perinatal diabetic women in six countries. The meta-analysis revealed that Internet-based self-monitoring interventions significantly decreased the level of maternal glycated hemoglobin A1c (z=2.23, P=.03) compared to usual care among perinatal diabetic women at postintervention. Moreover, Internet-based self-monitoring interventions significantly decreased the cesarean delivery rate (z=2.23, P=.03) compared to usual care among the mixed group at postintervention.ConclusionsThis review shows neonatal or other maternal outcomes are similar between Internet-based self-monitoring interventions and usual diabetes care among perinatal diabetic women. The long-term effects of the intervention must be confirmed in future studies using randomized controlled trials and follow-up data.

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“…Antenatal management of high-risk pregnancies from a distance has been accomplished for conditions ranging from maternal diabetes, hypertensive disorders, cervical insufficiency, and suspected fetal anomalies, including congenital heart disease (90)(91)(92). In Arkansas, telemedicine-supported care in the rural setting has been shown to reduce the need for in-person visits (where the mother would have to travel to the tertiary center) by nearly 50%, while maintaining the appropriate utilization of maternal-fetal medicine subspecialty consultations (91).…”

Section: Perinatal and Newborn Carementioning

confidence: 99%

Addressing health disparities in rural communities using telehealth

2015

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The regionalization of pediatric services has resulted in differential access to care, sometimes creating barriers to those living in underserved, rural communities. These disparities in access contribute to inferior healthcare outcomes among infants and children. We review the medical literature on telemedicine and its use to improve access and the quality of care provided to pediatric patients with otherwise limited access to pediatric subspecialty care. We review the use of telemedicine for the provision of pediatric subspecialty consultations in the settings of ambulatory care, acute and inpatient care, and perinatal and newborn care. Studies demonstrate the feasibility and efficiencies gained with models of care that use telemedicine. By providing pediatric subspecialty care in more convenient settings such as local primary care offices and community hospitals, pediatric patients are more likely to receive care that adheres to evidence-based guidelines. In many cases, telemedicine can significantly improve provider, patient, and family satisfaction, increase measures of quality of care and patient safety, and reduce overall costs of care. Models of care that use telemedicine have the potential to address pediatric specialists' geographic misdistribution and address disparities in the quality of care delivered to children in underserved communities.

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Antenatal management of at‐risk pregnancies from a distance

Cited by 19 publications

References 8 publications

The role of m-health in providing antenatal care in rural areas

The role of m-health in providing antenatal care in rural areas

Efficacy of Internet-Based Self-Monitoring Interventions on Maternal and Neonatal Outcomes in Perinatal Diabetic Women: A Systematic Review and Meta-Analysis

Addressing health disparities in rural communities using telehealth

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