Background In obstetric and gynecologic practices, synchronous telehealth services via chat message, voice calls, and video calls have been increasingly equipped to improve patients’ health care accessibility and clinical outcomes. Nevertheless, differences in clinical outcomes between communication tools remain unknown, especially in terms of safety. Objective This study compared the occurrence of emergency visits and hospitalization after telehealth services through different communication tools, including chat messages, voice calls, and video calls. Methods We collected data on obstetric and gynecologic concerns of women who consulted specialized doctors and midwives through a telehealth consulting service in Japan (Sanfujin-ka Online) between January 1, 2019, and December 31, 2020. The outcomes were emergency visits or hospitalizations at night after the consultation. Chi-square test and multivariate logistic regression analysis were performed to compare the clinical outcomes between the groups who received telehealth services via chat message, voice calls, and video calls. Results This study included 3635 participants. The mean age of the participants was 31.4 (SD 5.7) years, and the largest age group (n=2154, 59.3%) was 30-39 years. The numbers (or proportions) of those who received telehealth services via chat message, voice calls, and video calls were 1584 (43.5%), 1947 (53.6%), and 104 (2.9%), respectively. The overall incidence of the outcome was 0.7% (26/3635), including 10 (0.3%) cases of chat message, 16 (0.5%) cases of voice calls, and no video calls. There were no emergency visits that happened due to inappropriate advice. No significant difference in the proportions of the outcomes was observed between the communication tools (P=.55). The multivariate logistic regression analysis showed no significant differences in the outcome between those who used chat message and those who used voice calls (odds ratio 1.63, 95% CI 0.73-3.65). Conclusions The communication tools of telehealth services in obstetrics and gynecology did not show a significant difference in terms of emergency visits or hospitalizations after using the service.

BACKGROUND Many pregnant and lactating women are concerned about medication. Most women of reproductive age use medicines before, during, and after pregnancy, and they are aware that not all medicines are safe for them and their babies. While women face such concerns daily, they usually have few opportunities to communicate with healthcare professionals about safe medication use because of the limited availability of services and difficulty in making appointments. OBJECTIVE This study evaluated the user experience of a medical chatbot service that provides medicine use information to pregnant and lactating women by investigating users’ consultation categories, satisfaction levels, and post-use health problems. METHODS We collected the user data of a medical chatbot service providing medicine use information for pregnant and lactating women in Japan (Kusuribo) between December 13, 2021, and August 10, 2022. The satisfaction-related question was placed below the recommendation statements of the chatbot. An additional survey was distributed to collect post-health problem data from residents within one of the municipalities. The user status of this service (number of weeks of pregnancy, number of postpartum months, breastfeeding method, consultation categories, and preexisting conditions/complications) was presented, and the average level of satisfaction was calculated for all users and for each consultation category. The proportion of post-use problems was evaluated using the survey responses. χ2 and Fisher’s exact tests were conducted to assess the differences in user status and satisfaction levels. RESULTS The study included 1,000 records comprising 419 (41.9%) cases by pregnant women and 581 (58.1%) cases by lactating women. The response rate for the satisfaction question was 32.7%. The most frequently consulted categories in both groups were headache, cold symptoms, and hay fever symptoms. Of all users, 11.8% reported having preexisting medical or chronic complications, with bronchial asthma being the most prevalent (35.6%). The overall satisfaction rate was 93.9%, and the satisfaction levels of the two user groups showed no significant difference (P = .866). High satisfaction levels were observed across the consultation categories. An additional questionnaire was sent to 70 users, of whom 28 (40%) responded. None of the users indicated that they experienced health problems after using the service. CONCLUSIONS A medical chatbot service that provides medicine use information to women during pregnancy and lactation can achieve high satisfaction and safety.

Purpose Vaginal progesterone (VP) alone has been used as luteal support (LS) in HRT‐FET cycles without measuring serum progesterone concentrations (SPC) because it can achieve adequate intrauterine progesterone levels. However, several reports showed that the co‐administration of progestin produced better outcomes than VP alone. We tried to address this discrepancy, focusing on SPC. Methods VP was given to 180 women undergoing HRT‐FET. We measured SPC when pregnancy was diagnosed on day 14 of LS. We compared assisted reproductive technology outcomes between VP alone versus VP + dydrogesterone (D). Results When using VP alone, average SPC in the miscarriage cases (9.6 ng/mL) were significantly lower compared with the ongoing pregnancy (OP) cases (14.7 ng/mL). The cut‐off value for progesterone, 10.7 ng/mL, was a good predictor for the subsequent course of the pregnancy. Of 76 women receiving D ± VP from the start of LS and achieving a pregnancy, the numbers of OP were 44 (84.6%) in SPC ≥ 10.7 ng/mL and 20 (83.3%) in SPC ≤ 10.7 ng/mL with no significant difference. Conclusion VP alone resulted in lower SPC in some pregnant women in HRT‐FET cycles and exhibited a lower OP rate. The co‐administration of D improved an OP rate of low progesterone cases to the level comparable with non‐low progesterone cases.