Key result
Remote prenatal monitoring is linked to ~61% fewer maternal intensive care admissions versus routine care.
Why the study?
Gestational hypertensive disorders are major contributors to maternal mortality worldwide, and the relevance of remote monitoring programs for pregnant women at risk for GHD needs evaluation.
Does remote monitoring reduce Maternal Intensive Care admissions in pregnant women at risk for gestational hypertensive disorders?
Cohort (n=142)
No
Does remote monitoring reduce Maternal Intensive Care admissions in pregnant women at risk for gestational hypertensive disorders?
Absolute Event Rate: 29% vs 74%
p-value: p=<0.01
Remote monitoring of blood pressure and weight in pregnant women at risk for gestational hypertensive disorders may reduce maternal and neonatal intensive care admissions.
May reduce maternal ICU admissions; leaves open confirmation via randomized trials in gestational hypertension.
Background: Gestational hypertensive disorders (GHD) are major contributors to maternal mortality worldwide. In Ziekenhuis Oost- Limburg (Genk, Belgium), a remote monitoring (RM) program for pregnant women at risk for developing GHD was initiated in January 2015 to evaluate the relevance of a RM program. RM is a relatively new approach that broadly can be defined as the application of telecommunication technologies in interchanging medical data, information and services between healthcare providers and patients.Aim: Evaluation of the role of RM in the obstetrical care for pregnant women at risk for GHD.Methods: A retrospective study was conducted in 44 pregnant women who developed GHD and had a RM prenatal follow-up. They sent twice daily blood pressure measurements and once daily weight measurements to our Clinical Call Center. Those patients were compared with 98 patients with confirmed GHD in routine care (RC). The inclusion period started at the first of January 2015 and ended 31 December 2015. All the interchanged data were analyzed in detail. Primary endpoints were: number of prenatal consultations and Maternal Intensive Care (MIC) admissions. Secondary endpoints were: maternal and neonatal outcomes. SPSS was used for statistical analysis.Results: There is no difference between the two groups in maternal demographics, gestational age at the first prenatal visit, the total number of prenatal visits, CTG’s and echo’s during pregnancy, or amount of days admitted to the MIC. In RM versus RC, the total number of MIC admissions (29% versus 74%; p < 0.01) and the number of long-stay birthing admissions to the MIC (18% versus 64%; p < 0.01) were lower. Maternal and neonatal outcomes were not different for gestational age at delivery, birthweight, birthweight percentile, length, Apgar at 1 min or at 5 min and pH arterial or venous. In RM versus RC, the number of spontaneous deliveries is higher (47% versus 27%; p = 0.01) and the number of admissions to the NIC was lower (11.3% versus 29.2%; p = 0.02).Discussion: A lower number of NIC and MIC admissions in RM versus RC were observed in this retrospective study. When confirmed in a prospective setup, cost effectiveness of prenatal RM can be evaluated.
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Lanssens et al. (2016) conducted a cohort in Gestational hypertensive disorders (GHD) (n=142). Remote monitoring (RM) prenatal follow-up vs. Routine care (RC) was evaluated on Number of prenatal consultations and Maternal Intensive Care (MIC) admissions (p=<0.01). Remote prenatal monitoring in pregnant women with gestational hypertensive disorders was associated with fewer Maternal Intensive Care admissions compared to routine care (29% vs 74%; p<0.01).
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