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mHealth Solution for Remote Intrapartum Monitoring: A Feasibility Study

Authors:
Sujitkumar Hiwale
Navaneetha Krishnan
Jeevan Ram Addepalli
Shrutin Ulman

Keywords: feasibility study; inter-observer variability; intrapartum; mHealth; obstetrics; partograph, telemedicine.

Abstract:
The primary objective of this study was to evaluate feasibility of a mHealth-based Digital Labour and Delivery Solution (DLDS) for information exchange among healthcare professionals for remote intrapartum monitoring and decision making. The inclusion criteria for the study were a live-singleton pregnancy with cervical dilatation > 4 cm but < 8 cm at the time of admission, and presenting without any complication necessitating an immediate intervention. Throughout labour, all the subjects were monitored using conventional workflows. After each assessment, the in-charge doctor took one management decision from four possible options- (1) “Wait and watch”; (2) “Accelerate the labour”; (3) go for “Assisted vaginal delivery”; and (4) go for “Caesarean section”. For each subject, clinical history, examination, and decision details were entered in the DLDS. A doctor located remotely was asked to use the DLDS application to review two records per subject and take one of the four management decisions. The effectiveness of the DLDS for intrapartum information exchange was evaluated by comparing the decisions taken by a remote doctor using the DLDS to that of decisions taken by a doctor in a labour room. In total, 110 subjects were enrolled for the study. The overall agreement between the two doctors for 220 independent decision points was 0.764 using unweighted Cohen’s kappa and 0.723 using weighted Cohen’s kappa statistic. The substantial agreement between the two doctors for intrapartum decision making demonstrates the feasibility of the DLDS for remote intrapartum monitoring and decision making. However, further investigation is required to assess effectiveness and safety of DLDS for a general purpose remote intrapartum monitoring.

Pages: 118 to 122

Copyright: Copyright (c) IARIA, 2019

Publication date: February 24, 2019

Published in: conference

ISSN: 2308-4359

ISBN: 978-1-61208-688-0

Location: Athens, Greece

Dates: from February 24, 2019 to February 28, 2019