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Improving perinatal care in the rural regions worldwide by wireless enabled antepartum fetal monitoring: a demonstration project.

Tapia-Conyer R, Lyford S, Saucedo R, Casale M, Gallardo H, Becerra K, Mack J, Mujica R, Estrada D, Sanchez A, Sabido R, Meier C, Smith J - Int J Telemed Appl (2015)

Bottom Line: Remote monitoring resulted in markedly increased adherence (94.3% versus 45.1%).Conclusions.Improvement in maternal-fetal health outcomes requires integration of such technology into sociocultural context and addressing logistical challenges of access to appropriate emergency services.

View Article: PubMed Central - PubMed

Affiliation: Instituto Carlos Slim de la Salud, Insurgentes Sur 3500, 14060 Ciudad de México, DF, Mexico.

ABSTRACT
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.

No MeSH data available.


MiBebe fetal remote monitoring kit prototype technology with components as deployed in YUC, Mexico: (1) tablet/phone with fetal monitoring app; (2) fetal monitoring central unit; (3) FORA (blood pressure and glucometer); (4) pulse oximeter; (5) urine strips; (6) Toco; (7) elastic strap for central unit; (8) elastic strap for Toco.
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Related In: Results  -  Collection


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fig1: MiBebe fetal remote monitoring kit prototype technology with components as deployed in YUC, Mexico: (1) tablet/phone with fetal monitoring app; (2) fetal monitoring central unit; (3) FORA (blood pressure and glucometer); (4) pulse oximeter; (5) urine strips; (6) Toco; (7) elastic strap for central unit; (8) elastic strap for Toco.

Mentions: In 2010 the ICSS and the Gary and Mary West Health Institute (WHI), a nonprofit medical research organization based in La Jolla, CA, collaborated to conduct a feasibility demonstration project of remote, wireless antepartum fetal monitoring for high-risk pregnant women. WHI was established to help bring forth solutions to increase access to, improve the quality of, and lower the cost of healthcare. For this deployment, WHI contributed the MiBebe fetal remote monitoring prototype kits (Figure 1) to a rural clinic in Chemax, YUC, which is part of the AMANECE network. The project, called Salud Maya, was established within the AMANECE network of Valladolid, YUC, México. With the deployment of Salud Maya, WHI and ICSS introduced a clinic-based electronic maternal-fetal monitoring prototype kit to improve broad clinical education and communication to and from Valladolid General Hospital.


Improving perinatal care in the rural regions worldwide by wireless enabled antepartum fetal monitoring: a demonstration project.

Tapia-Conyer R, Lyford S, Saucedo R, Casale M, Gallardo H, Becerra K, Mack J, Mujica R, Estrada D, Sanchez A, Sabido R, Meier C, Smith J - Int J Telemed Appl (2015)

MiBebe fetal remote monitoring kit prototype technology with components as deployed in YUC, Mexico: (1) tablet/phone with fetal monitoring app; (2) fetal monitoring central unit; (3) FORA (blood pressure and glucometer); (4) pulse oximeter; (5) urine strips; (6) Toco; (7) elastic strap for central unit; (8) elastic strap for Toco.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4321852&req=5

fig1: MiBebe fetal remote monitoring kit prototype technology with components as deployed in YUC, Mexico: (1) tablet/phone with fetal monitoring app; (2) fetal monitoring central unit; (3) FORA (blood pressure and glucometer); (4) pulse oximeter; (5) urine strips; (6) Toco; (7) elastic strap for central unit; (8) elastic strap for Toco.
Mentions: In 2010 the ICSS and the Gary and Mary West Health Institute (WHI), a nonprofit medical research organization based in La Jolla, CA, collaborated to conduct a feasibility demonstration project of remote, wireless antepartum fetal monitoring for high-risk pregnant women. WHI was established to help bring forth solutions to increase access to, improve the quality of, and lower the cost of healthcare. For this deployment, WHI contributed the MiBebe fetal remote monitoring prototype kits (Figure 1) to a rural clinic in Chemax, YUC, which is part of the AMANECE network. The project, called Salud Maya, was established within the AMANECE network of Valladolid, YUC, México. With the deployment of Salud Maya, WHI and ICSS introduced a clinic-based electronic maternal-fetal monitoring prototype kit to improve broad clinical education and communication to and from Valladolid General Hospital.

Bottom Line: Remote monitoring resulted in markedly increased adherence (94.3% versus 45.1%).Conclusions.Improvement in maternal-fetal health outcomes requires integration of such technology into sociocultural context and addressing logistical challenges of access to appropriate emergency services.

View Article: PubMed Central - PubMed

Affiliation: Instituto Carlos Slim de la Salud, Insurgentes Sur 3500, 14060 Ciudad de México, DF, Mexico.

ABSTRACT
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.

No MeSH data available.