Telecardiotocography in prenatal telemedicine

Lieto, Andrea Di; Catalano, D; Pontillo, M.; Pollio, Fabrizio; Falco, Massimo De; Iannotti, Fausto; Schiraldi, Paola

doi:10.1258/1357633011936255

Cited by 14 publications

(8 citation statements)

References 6 publications

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“…Consequently, this technology may have the potential to reduce the rates of perinatal deaths. Wireless fetal heart monitors that transmit fetal heart rate data to a central server remotely either through modems [14] or Bluetooth [15] have been developed to allow real-time assessment of labour. Pilot studies have found the Bluetooth technology to be acceptable and feasible to both women and clinicians in both outpatient and inpatient settings of developed countries [15, 16].…”

Section: Introductionmentioning

confidence: 99%

Functionality and acceptability of a wireless fetal heart rate monitoring device in term pregnant women in rural Southwestern Uganda

Mugyenyi

Atukunda

Ngonzi

et al. 2017

BMC Pregnancy Childbirth

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BackgroundOver 3 million stillbirths occur annually in sub Saharan Africa; most occur intrapartum and are largely preventable. The standard of care for fetal heart rate (FHR) assessment in most sub-Saharan African settings is a Pinard Stethoscope, limiting observation to one person, at one point in time. We aimed to test the functionality and acceptability of a wireless FHR monitor that could allow for expanded monitoring capacity in rural Southwestern Uganda.MethodsIn a mixed method prospective study, we enrolled 1) non-laboring healthy term pregnant women to wear the device for 30 min and 2) non-study clinicians to observe its use. The battery-powered prototype uses Doppler technology to measure fetal cardiotocographs (CTG), which are displayed via an android device and wirelessly transmit to cloud storage where they are accessible via a password protected website. Prototype functionality was assessed by the ability to obtain and transmit a 30-min CTG. Three obstetricians independently rated CTGs for readability and agreement between raters was calculated. All participants completed interviews on acceptability.ResultsFifty pregnant women and 7 clinicians were enrolled. 46 (92.0%) CTGs were successfully recorded and stored. Mean scores for readability were 4.71, 4.71 and 4.83 (out of 5) with high agreement (intra class correlation 0.84; 95% CI 0.74 to 0.91). All pregnant women reported liking or really liking the device, as well as high levels of comfort, flexibility and usefulness of the prototype; all would recommend it to others. Clinicians described the prototype as portable, flexible, easy-to-use and a time saver. Adequate education for clinicians and women also seemed to improve correct usage and minimise concerns on safety of the device.ConclusionsThis prototype wireless FHR monitor functioned well in a low-resource setting and was found to be acceptable and useful to both pregnant women and clinicians. The device also seemed to have potential to improve the experience of the users compared with standard of care and expand monitoring capacity in settings where bulky, wired or traditional equipment are unreliable. Further research needs to investigate the potential impact and cost of such innovations to improve perinatal outcomes.

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Section: Introductionmentioning

confidence: 99%

Functionality and acceptability of a wireless fetal heart rate monitoring device in term pregnant women in rural Southwestern Uganda

Mugyenyi

Atukunda

Ngonzi

et al. 2017

BMC Pregnancy Childbirth

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“…Advances in technology have overcome some of these limitations. Standard central units are now often equipped with an interface that stores and subsequently transmits the fetal cardiotocograms via modem allowing remote analysis of fetal cardiotocographs in real time either by central unit screens on inpatient labor wards or on computers equipped with specific software [ 4 ]. These systems still require pregnant women to present to health care facilities equipped with standard monitors.…”

Section: Introductionmentioning

confidence: 99%

Wireless Fetal Heart Rate Monitoring in Inpatient Full-Term Pregnant Women: Testing Functionality and Acceptability

et al. 2015

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We tested functionality and acceptability of a wireless fetal monitoring prototype technology in pregnant women in an inpatient labor unit in the United States. Women with full-term singleton pregnancies and no evidence of active labor were asked to wear the prototype technology for 30 minutes. We assessed functionality by evaluating the ability to successfully monitor the fetal heartbeat for 30 minutes, transmit this data to Cloud storage and view the data on a web portal. Three obstetricians also rated fetal cardiotocographs on ease of readability. We assessed acceptability by administering closed and open-ended questions on perceived utility and likeability to pregnant women and clinicians interacting with the prototype technology. Thirty-two women were enrolled, 28 of whom (87.5%) successfully completed 30 minutes of fetal monitoring including transmission of cardiotocographs to the web portal. Four sessions though completed, were not successfully uploaded to the Cloud storage. Six non-study clinicians interacted with the prototype technology. The primary technical problem observed was a delay in data transmission between the prototype and the web portal, which ranged from 2 to 209 minutes. Delays were ascribed to Wi-Fi connectivity problems. Recorded cardiotocographs received a mean score of 4.2/5 (± 1.0) on ease of readability with an interclass correlation of 0.81(95%CI 0.45, 0.96). Both pregnant women and clinicians found the prototype technology likable (81.3% and 66.7% respectively), useful (96.9% and 66.7% respectively), and would either use it again or recommend its use to another pregnant woman (77.4% and 66.7% respectively). In this pilot study we found that this wireless fetal monitoring prototype technology has potential for use in a United States inpatient setting but would benefit from some technology changes. We found it to be acceptable to both pregnant women and clinicians. Further research is needed to assess feasibility of using this technology in busy inpatient settings.

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“…The aim of the present study was to assess the agreement in the interpretation of CTG traces between the computerized system 2CTG and experienced and inexperienced observers involved in the first Prenatal Telemedine project started in Italy, based on the 'TOCOMAT' system for conventional and computerized telecardiotocography [12].…”

Section: Introductionmentioning

confidence: 99%

Conventional and Computerized Antepartum Telecardiotocography

Lieto

Giani²,

Campanile³

et al. 2003

Gynecol Obstet Invest

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The study assessed the agreement in cardiotocogram interpretation between the 2CTG computerized system and experienced and inexperienced observers involved in a telecardiotocography project called ‘TOCOMAT’. Both observers and computer analyzed FHR baseline, FHR variability, and number of large accelerations and of decelerations. The k coefficient was calculated for the statistical analysis. The interobserver agreement about the evaluation of the FHR baseline and of the large accelerations was good; it was poor about the assessment of the FHR variability and the decelerations. Similar results were obtained for the agreement among observers and computer. The use of a computerized system provides exact values for most CTG parameters; the experts, however, should rely both on clinical features and on the computerized interpretation, to make decisions about management.

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Telecardiotocography in prenatal telemedicine

Abstract: Fig 1 Example of a computerized cardiotocographic trace.

Cited by 14 publications

References 6 publications

Functionality and acceptability of a wireless fetal heart rate monitoring device in term pregnant women in rural Southwestern Uganda

Functionality and acceptability of a wireless fetal heart rate monitoring device in term pregnant women in rural Southwestern Uganda

Wireless Fetal Heart Rate Monitoring in Inpatient Full-Term Pregnant Women: Testing Functionality and Acceptability

Conventional and Computerized Antepartum Telecardiotocography

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