Home telemonitoring may be a feasible approach for selected patients with high-risk pregnancies, according to a study presented at the Society for Maternal Fetal Medicine’s Global Congress.
The three-year cohort study included 117 single pregnancies enrolled in a home telemonitoring program between January 2021 and December 2023. Participants were monitored at home for conditions including premature rupture of membranes, pre-eclampsia and/or fetal growth restriction and other high-risk pregnancy complications.
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Telemonitoring began at a median gestational age of 32.4 weeks and continued for a median of 7 days. During monitoring, hospital readmission occurred in 32.6% of cases.
The median gestational age at delivery was 34.6 weeks, and 102 patients (87.2%) delivered preterm. Cesarean delivery occurred in 47.0% of cases. Labor began spontaneously during home monitoring in 9.4% of pregnancies, although no patients delivered at home.
No maternal or intrauterine fetal deaths occurred during the monitoring period. However, complications were reported in 36 patients (30.8%). Chorioamnionitis was the most common complication, occurring in 21 patients (17.9%), followed by worsening pre-eclampsia in 11 patients (9.4%). Placental abruption and bleeding placenta previa each occurred in 2 patients (1.7%).
Researchers said the findings show that home telemonitoring could potentially improve access and patient experience under certain circumstances, although further research is needed to evaluate these potential benefits.
The findings may also be relevant to other pregnancies requiring close monitoring, including those at risk for fetal and neonatal alloimmune thrombocytopeniaFetal and neonatal alloimmune thrombocytopenia A rare condition in which a mother’s immune system attacks fetal platelets, leading to dangerously low platelet levels before and/or after birth. (FNAIT). However, FNAIT was not specifically evaluated in this study, and the researchers did not assess whether home telemonitoring is appropriate for pregnancies affected by or at risk for FNAIT. Management of FNAIT can involve specialized fetal monitoringFetal monitoring Can include Ultrasounds, Doppler studies and other evaluations that help the care team track fetal health and watch for potential complications. and treatment plans based on the individual pregnancy’s risk.
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Because the study was retrospective and included a relatively small number of pregnancies at a single tertiary hospital, the findings do not establish that home telemonitoring is safer or more effective than inpatient care.
“This study indicates that home telemonitoring may be a viable strategy for selected high-risk pregnancies, contingent upon rigorous patient selection and strict adherence to clinical protocols,” the authors concluded.
