Patient Preferences for Prenatal and Postpartum Care Delivery

Peahl, Alex; Novara, Alli; Heisler, Michele; Dalton, Vanessa K.; Moniz, Michelle H.; Smith, Roger

doi:10.1097/aog.0000000000003731

Cited by 68 publications

(78 citation statements)

References 25 publications

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“…The correlation with economic di culties and education is consistent with the literature (16), and some studies suggest that COVID 19 pandemic may even worsen the social inequalities (18). Regarding the fact that a reduction of face to face visits could have occurred to women during the restrictions; a recent survey shows that patients are actually open to alternative models of prenatal care, including remote monitoring (19). Future survey could be done in the same population in order to nd out if some changes are considered positively.…”

Section: Discussionsupporting

confidence: 77%

A Survey Among Italian Pregnant Women and New-mothers During the COVID-19 Pandemic Lockdown.

Stampini

Monzani

Caristia

et al. 2020

Preprint

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In response to the COVID-19 pandemics, drastic measures for social distancing have been introduced also in Italy. The purpose of this study was to describe some aspects of lifestyle, access to health services, and mental wellness of Italian pregnant women and new-mothers during the lockdown. We carried out a web-based survey to assess how pregnant women and new-mothers were coping with the lockdown. Expected outcomes were categorized in different analysis domains: psychological well-being and support, physical exercise, dietary habits, access to care, delivery and obstetric care, neonatal care and breastfeeding.We included 742 respondents (response rate 86.2%), 603 were pregnant (81.3%) and 139 (18.7%) had delivered during lockdown. We found a high score for anxiety and depression in 62.7% of pregnant women and 61.9% of new-mothers. During the lockdown, 61.9% of pregnant women reduced their physical exercise, and 79.8% reported to eat in a healthier way. 94.2% of new-mothers reported to have breastfed their babies during hospital staying. Regarding the impact of restrictive measures on breastfeeding, no impact was reported by 56.1% of new-mothers, a negative impact by 36.7%.The higher prevalence of anxiety and depressive symptoms in pregnant women and new-mothers should be a public health issue. Clinicians might also consider to recommend and encourage “home” physical exercise. On the other hand, most women improved their approach towards healthy eating during the lockdown and a very high breastfeeding rate was reported soon after birth: these data are an interesting starting point to develop new strategies for public health.

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Section: Discussionsupporting

confidence: 77%

A Survey Among Italian Pregnant Women and New-mothers During the COVID-19 Pandemic Lockdown.

Stampini

Monzani

Caristia

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Recent data suggest that patients are open to utilizing telemedicine for routine care. 11,12 For obstetrical patients with barriers to access, such as geography, transportation, lack of time away from work, and lack of childcare, telemedicine models may increase adherence to care in both the prenatal and postpartum settings. 13 Nurses in our program were able to coordinate social work services, help navigate transportation barriers, provide a personal connection, and direct patients toward medical care when indicated The multidisciplinary telemedicine model was an effective way to reach a diverse population of patients, including 1 in 6 patients who required an interpreter, which was readily available by phone using this approach.…”

Section: Discussionmentioning

confidence: 99%

A multidisciplinary telemedicine model for management of coronavirus disease 2019 (COVID-19) in obstetrical patients

Reforma

Duffy

Collier

et al. 2020

American Journal of Obstetrics & Gynecology MFM

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BACKGROUND: The COVID-19 pandemic caused by the SARS-CoV-2 has increased the demand for inpatient healthcare resources; however, approximately 80% of patients with COVID-19 have a mild clinical presentation and can be managed at home. OBJECTIVE: This study aimed to describe the feasibility and clinical and process outcomes associated with a multidisciplinary telemedicine surveillance model to triage and manage obstetrical patients with known exposures and symptoms of COVID-19. STUDY DESIGN: We implemented a multidisciplinary telemedicine surveillance model with obstetrical physicians and nurses to standardize ambulatory care for obstetrical patients with confirmed or suspected COVID-19 based on the symptoms or exposures at an urban academic tertiary care center with multiple hospital-affiliated and community-based practices. All pregnant or postpartum patients with COVID-19 symptoms, exposures, or hospitalization were eligible for inclusion in the program. Patients were assessed by means of regular nursing phone calls and were managed according to illness severity. Patient characteristics and clinical and process outcomes were abstracted from the electronic medical record. RESULTS: A total of 135 patients were enrolled in the multidisciplinary telemedicine model from March 17 to April 19, 2020, of whom 130 were pregnant and 5 were recently postpartum. In this study, 116 of 135 patients (86%) were managed solely in the outpatient setting and did not require an in-person evaluation; 9 patients were ultimately admitted after ambulatory or urgent evaluations, and 10 patients were observed after hospital discharge. Although only 50% of the patients were tested secondary to limitations in ambulatory testing, 1 in 3 of those patients received positive results for SARS-CoV-2 (N¼22, 16% of entire cohort). Patients were enrolled in the telemedicine model for a median of 7 days (interquartile range, 4e8) and averaged 1 phone call daily, resulting in 891 nursing calls and 20 physician calls over 1 month. CONCLUSION: A multidisciplinary telemedicine surveillance model for outpatient management of obstetrical patients with COVID-19 symptoms and exposures is feasible and resulted in rates of ambulatory management similar to those seen in nonpregnant patients. A centralized model for telemedicine surveillance of obstetrical patients with COVID-19 symptoms may preserve inpatient resources and prevent avoidable staff and patient exposures, particularly in centers with multiple ambulatory practice settings.

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“…Existen estudios previos de satisfacción usuaria en un modelo mixto de atención en Estados Unidos, en que se comparó a las pacientes que recibieron control prenatal habitual con aquellas en que se implementó un control mixto de visitas presenciales y virtuales, los resultados mostraban un nivel de satisfacción mayor en aquellas pacientes que recibieron el modelo de atención mixto 21 . Por otro lado, un reporte reciente del período pre-pandemia en que se encuestó a mujeres post-parto en relación a las preferencias en cuanto al control pre y post-natal, mostró opiniones diversas que favorecían una planificación de control flexible, con buena aceptación global del modelo virtual 22 . El estudio de Fryer et al donde se evaluó la satisfacción de pacienes con el control prenatal virtual en el contexto de pandemia por COVID-19, mostró altos niveles de aprobación de la telesalud o telemedicina 20 .…”

Section: Discussionunclassified

Evaluación de un modelo remoto de seguimiento de pacientes embarazadas y puérperas con infección por SARS-CoV-2

et al. 2020

Rev. chil. obstet. ginecol.

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Introduction: Given the scenario of obstetric patients diagnosed with the new coronavirus disease , the need for proper follow-up both obstetric and of the infection, during the period of home isolation, is essential. A remote monitoring program was developed by the Maternal Fetal Medicine Unit (MFM) of our center from the diagnosis of the infection until medical discharge according to the current criteria of the Ministry of Health (MINSAL). Objective: To assess patient satisfaction of remote monitoring of pregnant and postpartum patients diagnosed with SARS-CoV-2 infection. Methods: This is a descriptive-survey research. We performed a patient satisfaction survey through an online platform to pregnant and postpartum patients with remote monitoring for SARS-CoV-2 infection in our center. The survey was anonymous and voluntary. The instrument for this purpose was the Spanish adapted version of "Telehealth Usability Questionnaire" (TUQ) that has been previously validated. Results: The survey was answered by 94,5% of the patients. The results show that 86% of the patients rated the virtual control as "Very Good" or "Good"; 91% did not experienced technical problems. 14% of the patients prefer virtual control, 26% prefer face-to-face control and 60% both virtual and face-to-face control. 80% fulfilled all their needs with virtual control. Conclusions: In the context of pandemic and SARS-CoV-2 infection, remote monitoring has been positively evaluated with acceptable levels of patient's satisfaction.

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Patient Preferences for Prenatal and Postpartum Care Delivery

Cited by 68 publications

References 25 publications

A Survey Among Italian Pregnant Women and New-mothers During the COVID-19 Pandemic Lockdown.

A Survey Among Italian Pregnant Women and New-mothers During the COVID-19 Pandemic Lockdown.

A multidisciplinary telemedicine model for management of coronavirus disease 2019 (COVID-19) in obstetrical patients

Evaluación de un modelo remoto de seguimiento de pacientes embarazadas y puérperas con infección por SARS-CoV-2

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