Improving Perinatal Care in the Rural Regions Worldwide by Wireless Enabled Antepartum Fetal Monitoring: A Demonstration Project

الملخص EN

Background.

Fetal and neonatal morbidity and mortality are significant problems in developing countries; remote maternal-fetal monitoring offers promise in addressing this challenge.

The Gary and Mary West Health Institute and the Instituto Carlos Slim de la Salud conducted a demonstration project of wirelessly enabled antepartum maternal-fetal monitoring in the state of Yucatán, Mexico, to assess whether there were any fundamental barriers preventing deployment and use.

Methods.

Following informed consent, high-risk pregnant women at 27–29 weeks of gestation at the Chemax primary clinic participated in remote maternal-fetal monitoring.

Study participants were randomized to receive either prototype wireless monitoring or standard-of-care.

Feasibility was evaluated by assessing technical aspects of performance, adherence to monitoring appointments, and response to recommendations.

Results.

Data were collected from 153 high-risk pregnant indigenous Mayan women receiving either remote monitoring (n=74) or usual standard-of-care (n=79).

Remote monitoring resulted in markedly increased adherence (94.3% versus 45.1%).

Health outcomes were not statistically different in the two groups.

Conclusions.

Remote maternal-fetal monitoring is feasible in resource-constrained environments and can improve maternal compliance for monitoring sessions.

Improvement in maternal-fetal health outcomes requires integration of such technology into sociocultural context and addressing logistical challenges of access to appropriate emergency services.