Telehealth in antenatal care: recent insights and advances

Abstract

Background For decades, antenatal care in high-resource settings has involved 12–14 face-to-face visits across pregnancy. The COVID-19 pandemic forced many care providers to rapidly embrace telehealth to reduce face-to-face visits. Here we review recent advances in telehealth used to provide antenatal care. Main body We conducted a narrative review examining the impact of telehealth on obstetric care. Two broad types of telehealth are used in antenatal care. The first is real-time telehealth, where consultations are done virtually instead of face-to-face. The second is remote monitoring, where in-clinic physical examinations are replaced with at-home alternatives. These can include blood pressure monitoring, fetal heart rate monitoring, and emerging technologies such as tele-ultrasound. Large cohort studies conducted during the pandemic era have shown that telehealth appears not to have increased adverse clinical outcomes for mothers or babies. However, further studies may be required to confidently conclude rare outcomes are unchanged, such as maternal mortality, serious morbidity, or stillbirth. Health economic studies suggest telehealth has the potential to reduce the financial cost of care provision. Telehealth in antenatal care seems to be acceptable to both pregnant women and healthcare providers. Conclusion Adoption of telehealth technologies may improve the antenatal care experience for women and reduce healthcare expenditure without adversely impacting health outcomes for the mother or baby. More studies are warranted to confirm telehealth does not alter the risk of rare outcomes such as maternal or neonatal mortality.

Telegenetics to provide comprehensive prenatal diagnosis

“…Additionally, multiple studies have shown that prenatal telegenetic consultations are as accurate and effective in conveying information as in-person consultations. 31,[38][39][40] Patients have high levels of satisfaction with virtual visits and appreciate the convenience, personalized interactions, and the ability to involve family members in discussions without logistical challenges. 37 When compared with in-person genetic service delivery, most patients reported reduced anxiety and high level of knowledge.…”

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“…Through telehealth, a drastic reduction in adverse intrapartum and postpartum outcomes, which may have been associated with delayed care initiation due to poor access to a caregiving facility, has been witnessed. 41 Additionally, telemedicine is set to replace most in-person antenatal and postpartum supervisory care. For example, antenatal care models recommend at least 14 antenatal care contacts for low-risk pregnancies; telehealth offers a platform supplementing physical care sessions, consequently cutting down on the cost of accessing healthcare facilities and the resultant loss of work hours.…”

“…For example, antenatal care models recommend at least 14 antenatal care contacts for low-risk pregnancies; telehealth offers a platform supplementing physical care sessions, consequently cutting down on the cost of accessing healthcare facilities and the resultant loss of work hours. 39 , 41 - 43 …”

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“…ACOG classifies the telehealth models into three broad categories, namely, synchronous (real-time), asynchronous (sending medical imaging for later interpretation), or remote monitoring [ 34 ]. The COVID-19 pandemic accelerated the adoption of telehealth services for pregnant women, proving to be both safe and cost-effective.…”