HealthDay News — Home management, including remote self-monitoring, is feasible and safe in terms of maternal and fetal outcomes for intermediate- and high-risk pregnant women, according to a study published online Dec. 7 in Acta Obstetricia et Gynecologica Scandinavica.
Anne Rahbek Zizzo, M.D., Ph.D., from Aarhus University Hospital in Denmark, and colleagues evaluated the outcome and safety of extended remote self-monitoring of maternal and fetal health in intermediate- and high-risk pregnancies. Self-monitoring included C-reactive protein, nonstress test by cardiotocography, temperature, blood pressure, and heart rate, and a questionnaire concerning maternal and fetal well-being. The analysis included 400 singleton pregnancies complicated by preterm premature rupture of membranes (PPROM), fetal growth restriction, preeclampsia, gestational diabetes mellitus, a high risk for preeclampsia, or a history of previous fetal or neonatal loss.
The researchers observed no severe maternal complications, although nine fetal or neonatal deaths occurred, all secondary to malformations, severe fetal growth restriction, extreme prematurity, or lung hypoplasia in cases of PPROM before 24 weeks. Even in the latter group, fetal and neonatal survival was 78 percent and increased to 97 percent when PPROM occurred after a gestational age 23+6 weeks. No fetal or neonatal deaths were attributable to home management.
“An extended setup of home monitoring, including remote self-monitoring in intermediate- and high-risk pregnancies was feasible, safe, and with outcomes comparable to or better than reported with inpatient care,” the authors write.