Subscribe to RSS
Maternal Perinatal Telemonitoring in the Context of the Coronavirus Disease 2019 Pandemic in a Tertiary Health Center in PeruFunding This study was funded by Fondo Nacional de Desarrollo Tecnológico y de Innovación Tecnológico (FONDECYT) and Consejo Nacional de Ciencia, Tecnología e Innovación Tecnológica (CONCYTEC-PERU; Grant contract number 067-2020-Fondecyt).
Objective This study aimed to describe the characteristics of a telemonitoring program that was rapidly implemented in our institution as a response to the coronavirus disease 2019 (COVID-19) pandemic, as well as the maternal and perinatal outcomes of women who attended this program.
Study Design Retrospective study of patients via phone-call telemonitoring during the peak period of the COVID-19 pandemic (May 2020–August 2020). Maternal and perinatal outcomes were collected and described. Health providers' satisfaction with the telemonitoring program was assessed via an email survey.
Results Twenty-three (69.7%) health providers answered the survey. The mean age was 64.5 years, 91.3% were OB/GYN (obstetrician-gynecologist) doctors, and 95% agreed that telemonitoring is an adequate method to provide health care when in-person visits are difficult. The 78.7% of scheduled telemonitoring consultations were finally completed. We performed 2,181 telemonitoring consultations for 616 pregnant women and 544 telemonitoring consultations for puerperal women. Other medical specialties offering telemonitoring included gynecology, reproductive health, family planning, cardiology, endocrinology, and following up with patients with reactive serology to severe respiratory syndrome coronavirus 2 (SARS-CoV-2). The majority of the population attending our telemonitoring program were categorized as the lowest strata, i.e., III and IV, according to the Human Development Index, and approximately 42% were deemed as high-risk pregnant women. Additionally, we reported the perinatal outcomes of 424 (63%) pregnant women, the most relevant finding being that approximately 53% of them had cesarean sections.
Conclusion Telemonitoring is an adequate method of continuing the provision of prenatal care when in-person visits are difficult in situations such as the COVID-19 pandemic. Telemonitoring is feasible even in institutions with no or little experience in telemedicine. The perinatal outcomes in women with telemonitoring seem to be similar to that in the general population.
Telemonitoring for prenatal care is feasible even in low-income countries and in a critical scenario.
OB/GYN doctors agreed with that telemonitoring is an adequate method to provide prenatal care.
Maternal and perinatal outcomes are similar in women attending a telemonitoring program.
Received: 07 February 2021
Accepted: 18 February 2022
Accepted Manuscript online:
03 March 2022
Article published online:
12 June 2022
© 2022. Thieme. All rights reserved.
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
- 1 Novoa RH, Quintana W, Llancarí P, Urbina-Quispe K, Guevara-Ríos E, Ventura W. Maternal clinical characteristics and perinatal outcomes among pregnant women with coronavirus disease 2019. A systematic review. Travel Med Infect Dis 2021; 39: 101919
- 2 Allotey J, Stallings E, Bonet M. et al; for PregCOV-19 Living Systematic Review Consortium. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ 2020; 370: m3320
- 3 Center for Connected Health Policy.. What is Telehealth?. Accessed December 18, 2020 at: https://www.cchpca.org/about/about-telehealth
- 4 Implementing Telehealth in Practice. Implementing telehealth in practice: ACOG Committee Opinion Summary, Number 798. Obstet Gynecol 2020; 135 (02) 493-494
- 5 Hollander JE, Carr BG. Virtually perfect? Telemedicine for COVID-19. N Engl J Med 2020; 382 (18) 1679-1681
- 6 Song X, Liu X, Wang C. The role of telemedicine during the COVID-19 epidemic in China-experience from Shandong province. Crit Care 2020; 24 (01) 178
- 7 Montenegro P, Pinillos L, Young F. et al. Telemedicine and the current opportunities for the management of oncological patients in Peru in the context of COVID-19 pandemic. Crit Rev Oncol Hematol 2021; 157: 103129
- 8 Vivanti AJ, Deruelle P, Picone O. et al. Follow-up for pregnant women during the COVID-19 pandemic: French national authority for health recommendations. J Gynecol Obstet Hum Reprod 2020; 49 (07) 101804
- 9 Schinköthe T, Gabri MR, Mitterer M. et al. A web- and app-based connected care solution for COVID-19 in- and outpatient care: qualitative study and application development. JMIR Public Health Surveill 2020; 6 (02) e19033
- 10 Ministerio de Salud.. Directiva para la implementación y desarrollo de los servidores de telemedicina síncrona y asíncrona. Resolución Ministerial N° 117–2020-MINSA. Lima-Perú; 2020
- 11 Instituto Nacional Materno Perinatal.. Resolución Directoral N° 099–2020-DG-INMP/MINSA. Plan de emergencia COVID-19 Telesalud, Teleorientacion para la atención de pacientes de bajo riesgo y atención presencial restringida para pacientes con riesgo de complicación, del Instituto Nacional Materno Perinatal. Lima, Perú;. 2020 . Accessed March 17, 2022 at: https://www.gob.pe/institucion/inmp/normas-legales/1204368-099-2020-dg-inmp-minsa
- 12 Bhandari NR, Payakachat N, Fletcher DA. et al. Validation of newly developed surveys to evaluate patients' and providers' satisfaction with telehealth obstetric services. Telemed J E Health 2020; 26 (07) 879-888
- 13 UNDP.. Human Development Reports. Human Development Index (HDI): United Nations Development Programme. Accessed December 9, 2020 at: http://hdr.undp.org/en/content/human-development-index-hdi
- 14 PNUD.. El reto de la igualdad. Una lectura de las dinámicas territoriales en el Perú. Lima, Peru: Programa de las Naciones Unidas para el Desarrollo – PNUD; 2019
- 15 DeNicola N, Grossman D, Marko K. et al. Telehealth interventions to improve obstetric and gynecologic health outcomes: a systematic review. Obstet Gynecol 2020; 135 (02) 371-382
- 16 Madden N, Emeruwa UN, Friedman AM. et al. Telehealth uptake into prenatal care and provider attitudes during the COVID-19 pandemic in New York City: a quantitative and qualitative analysis. Am J Perinatol 2020; 37 (10) 1005-1014
- 17 Futterman I, Rosenfeld E, Toaff M. et al. Addressing disparities in prenatal care via telehealth during COVID-19: prenatal satisfaction survey in East Harlem. Am J Perinatol 2021; 38 (01) 88-92
- 18 Limaye MA, Lantigua-Martinez M, Trostle ME. et al. Differential uptake of telehealth for prenatal care in a large New York City academic obstetrical practice during the COVID-19 pandemic. Am J Perinatol 2021; 38 (03) 304-306
- 19 Sutton D, Fuchs K, D'Alton M, Goffman D. Universal screening for SARS-CoV-2 in women admitted for delivery. N Engl J Med 2020; 382 (22) 2163-2164
- 20 Vidal-Anzardo M, Solis G, Solari L. et al. Evaluación en condiciones de campo de una prueba serológica rápida para detección de anticuerpos IgM e IgG contra SARS-CoV-2. Rev Peru Med Exp Salud Publica 2020; 37 (02) 203-209
- 21 Ventura W, Ventura-Laveriano J, Nazario-Redondo C. Perinatal outcomes associated with subsequent pregnancy among adolescent mothers in Peru. Int J Gynaecol Obstet 2012; 117 (01) 56-60
- 22 Justman N, Shahak G, Gutzeit O. et al. Lockdown with a price: the impact of the COVID-19 pandemic on prenatal care and perinatal outcomes in a tertiary care center. Isr Med Assoc J 2020; 22 (09) 533-537
- 23 Xie W, Dai P, Qin Y, Wu M, Yang B, Yu X. Effectiveness of telemedicine for pregnant women with gestational diabetes mellitus: an updated meta-analysis of 32 randomized controlled trials with trial sequential analysis. BMC Pregnancy Childbirth 2020; 20 (01) 198
- 24 Pflugeisen BM, McCarren C, Poore S, Carlile M, Schroeder R. Virtual visits: managing prenatal care with modern technology. MCN Am J Matern Child Nurs 2016; 41 (01) 24-30
- 25 van den Heuvel JFM, Ayubi S, Franx A, Bekker MN. Home-based monitoring and telemonitoring of complicated pregnancies: nationwide cross-sectional survey of current practice in the Netherlands. JMIR Mhealth Uhealth 2020; 8 (10) e18966
- 26 Chen M, Liu X, Zhang J. et al. Characteristics of online medical care consultation for pregnant women during the COVID-19 outbreak: cross-sectional study. BMJ Open 2020; 10 (11) e043461
- 27 Reforma LG, Duffy C, Collier AY. et al. A multidisciplinary telemedicine model for management of coronavirus disease 2019 (COVID-19) in obstetrical patients. Am J Obstet Gynecol MFM 2020; 2 (04) 100180
- 28 Holcomb D, Faucher MA, Bouzid J, Quint-Bouzid M, Nelson DB, Duryea E. Patient perspectives on audio-only virtual prenatal visits amidst the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. Obstet Gynecol 2020; 136 (02) 317-322
- 29 Alexander GR, Kotelchuck M. Assessing the role and effectiveness of prenatal care: history, challenges, and directions for future research. Public Health Rep 2001; 116 (04) 306-316
- 30 Fryer K, Delgado A, Foti T, Reid CN, Marshall J. Implementation of obstetric telehealth during COVID-19 and beyond. Matern Child Health J 2020; 24 (09) 1104-1110