Computerized Childbirth Monitoring Tools for Health Care Providers Managing Labor: A Scoping Review

Abstract

BackgroundProper monitoring of labor and childbirth prevents many pregnancy-related complications. However, monitoring is still poor in many places partly due to the usability concerns of support tools such as the partograph. In 2011, the World Health Organization (WHO) called for the development and evaluation of context-adaptable electronic health solutions to health challenges. Computerized tools have penetrated many areas of health care, but their influence in supporting health staff with childbirth seems limited.ObjectiveThe objective of this scoping review was to determine the scope and trends of research on computerized labor monitoring tools that could be used by health care providers in childbirth management.MethodsWe used key terms to search the Web for eligible peer-reviewed and gray literature. Eligibility criteria were a computerized labor monitoring tool for maternity service providers and dated 2006 to mid-2016. Retrieved papers were screened to eliminate ineligible papers, and consensus was reached on the papers included in the final analysis.ResultsWe started with about 380,000 papers, of which 14 papers qualified for the final analysis. Most tools were at the design and implementation stages of development. Three papers addressed post-implementation evaluations of two tools. No documentation on clinical outcome studies was retrieved. The parameters targeted with the tools varied, but they included fetal heart (10 of 11 tools), labor progress (8 of 11), and maternal status (7 of 11). Most tools were designed for use in personal computers in low-resource settings and could be customized for different user needs.ConclusionsResearch on computerized labor monitoring tools is inadequate. Compared with other labor parameters, there was preponderance to fetal heart monitoring and hardly any summative evaluation of the available tools. More research, including clinical outcomes evaluation of computerized childbirth monitoring tools, is needed.

Acceptability and Barriers to Use of the ASMAN Provider-Facing Electronic Platform for Peripartum Care in Public Facilities in Madhya Pradesh and Rajasthan, India: A Qualitative Study Using the Technology Acceptance Model-3

“…mHealth involves medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants, and other wireless devices [ 1 ]. Seizing upon the promise of mobile digital platforms for data collection and dissemination, health systems are increasingly piloting, adopting, and scaling up provider-facing mHealth applications to improve health care delivery; registries and vital events tracking; electronic health records (EHRs); data collection and reporting; electronic clinical decision support systems (e-CDSSs); and provider training, education, and supportive supervision [ 2 , 3 , 4 , 5 , 6 ]. Multiple reviews have shown that mHealth approaches, particularly those that employ e-CDSSs as a central component, can lead to improvements in provider behaviors as well as patient outcomes [ 7 , 8 , 9 , 10 ], although few have been successfully scaled up [ 11 ].…”

Use of an electronic Partograph: feasibility and acceptability study in Zanzibar, Tanzania

“…The ePartogram reinforces SBA clinical expertise by supporting appropriate monitoring and care during labor. Several mobile and computer-based tools are under development with the shared vision of improving care during labor [ 10 , 15 , 16 ]; however, most of these products are in the early introduction phase and further rigorous research is needed [ 17 ].…”

Expert perspectives on essential parameters to monitor during childbirth in low resource settings: a Delphi study in sub-Saharan Africa

“…Besides, we didn’t seek new parameters for childbirth monitoring but rather the identification of the (non)contentious ones and seek convergence. The initial round was informed by a synthesis of the existing childbirth management guidelines and literature review on partograph use [2, 7, 15, 18, 19, 21, 23, 25, 30]. A synopsis was provided to potential participants in the invitation email and in the introduction of the questionnaires.…”

“…Other researchers recommended the cessation of using community-generated childbirth monitoring curves in making decisions for individuals [24]. A review of the computerized childbirth monitoring tools found a limited number of them but they were not suited to the diverse birth monitoring contexts in SSA [25]. The WHO called for research into other paper or digital labour monitoring tools that are more efficacious and acceptable to maternity service providers to guide clinical decisions, avoid excessive interventions and improve birth outcomes [20, 26].…”