Is remote pregnancy monitoring effective in managing high-risk pregnancies before, during, and after delivery? This article answers this question and highlights the benefits of using home pregnancy monitoring for preventing complications and improving maternal and fetal outcomes.
Telehealth and Remote Pregnancy Monitoring
Pregnant patients require many obstetrics visits to help spot health concerns early when complications are easier to treat. However, high-risk pregnancies require even more in-office visits. While digital health innovations such as virtual telehealth visits do not replace office prenatal care visits, they can be helpful for at-risk pregnant patients, especially those on bed rest. Remote monitoring of maternal physiology during pregnancy is particularly valuable for patients with cardiovascular disease or excessive weight gain.
Telemedicine research topics report the effectiveness of telehealth and remote patient monitoring (RPM) for chronic disease, pregnancy, and short-term illness care. This next section overviews remote pregnancy monitoring and how it works.
Remote Pregnancy Monitoring: What is it?
According to the CDC Vital Signs report, about 4 in 5 pregnancy-related deaths are preventable. This is why high-risk pregnancies call for extra vigilance. Remote patient monitoring is one preventive solution for pregnant patients.
When a patient takes a vital sign measurement with a remote patient monitoring device, the reading is sent to their obstetrician in real-time. The obstetrician can access the patient’s daily readings through a dashboard. By monitoring an at-risk patients’ vital signs regularly, obstetricians gain a better understanding of their patient’s condition.
An alert is triggered when a patient’s reading is above or below a set threshold. The obstetrician is notified and can step in if medical attention is needed. With remote pregnancy monitoring, patients know that their health team is monitoring their condition. RPM helps patients avoid long trips to some in-office visits, prevent exposure to illnesses. Finally, RPM increases medical access for rural patients far from high-risk specialists.
Remote Pregnancy Monitoring for Managing High-Risk Conditions
Remote patient monitoring is one strategy offered in women’s health prevention that can be used during and after pregnancy. Women who already have hypertension, cardiovascular/heart disease, diabetes, kidney disease, and obesity are at increased risk for an at-risk pregnancy. In addition, high-risk pregnancies can cause gestational hypertension and gestational diabetes. These high-risk patients benefit from close observation through remote pregnancy monitoring.
Pregnancy-related death can occur up to a year after giving birth. Most pregnancy-related deaths can be prevented by addressing these factors:
- Appropriate and high-quality care
- Missed or delayed diagnoses
- Lack of knowledge about warning signs
1) Cardiovascular Disease
The leading cause of death during and after pregnancy is heart disease and stroke, leading to more than 1 in 3 deaths or 34%. Cardiomyopathy, a weakened heart muscle, is the leading cause of death throughout pregnancy and after delivery. Other leading causes of maternal death during and after pregnancy include infections and severe bleeding.
2) Gestational Hypertension
This condition occurs when a patient develops high blood pressure only during pregnancy and does not have protein in their urine or other heart or kidney problems. It occurs in about 6% of all pregnancies and can put the baby at risk for preterm delivery and the mother at risk for problems during the pregnancy, including:
Gestational hypertension is often diagnosed after 20 weeks of gestation or close to delivery and usually goes away after giving birth. Although, some women with gestational hypertension have an increased risk of developing chronic hypertension later in life.
3) Gestational Diabetes
Remote pregnancy monitoring helps manage gestational diabetes in pregnant women. Gestational diabetes can develop during pregnancy in patients who don’t already have diabetes. Every year, 2% to 10% of pregnancies in the United States are affected by gestational diabetes. Managing gestational diabetes will help ensure you have a healthy pregnancy and baby.
Gestational diabetes increases the risk of high blood pressure during pregnancy. It also increases the risk of delivery by cesarean section. Likewise, the baby is at higher risk of:
- Weighing 9 pounds or more, making delivery difficult.
- Premature birth, resulting in respiratory problems.
- Low blood sugar.
- Developing type 2 diabetes later in life.
Remote Pregnancy Monitoring: Effective After Delivery
The U.S. maternal death ratio is higher than in many countries, with half of maternal deaths occuring after delivery. A pilot study of outpatient postpartum blood pressure monitoring showed that patient education and outpatient monitoring during the COVID-19 pandemic was “instrumental” for outpatient postpartum hypertension care. In addition, pregnant patients reported high satisfaction with remote patient monitoring for managing hypertension.
Another study found that compared to regular office check-ups, patients who use remote blood pressure monitoring were much more likely to have their blood pressure checked within the first 10 days postpartum (92.2%–94.4% compared to 43.7%–60.3%). Research also shows that remote blood pressure monitoring is applied broadly in clinical practice, with rates as high as 95.5%. Sharing multiple readings helps doctors make better decisions about starting or adjusting blood pressure medication.
The largest study in remote patient monitoring for obstetric hypertension showed that compared to traditional blood pressure monitoring, remote blood pressure monitoring helped improve blood pressure monitoring and aided in better postpartum blood pressure control in 937 obstetric patients.
The American College of Obstetricians and Gynecologists (ACOG) has called to expand remote patient monitoring for pregnant and postpartum patients. The organization believes access to remote pregnancy monitoring before, during, and after pregnancy should be considered for broad-scale and long-term implementation beyond the pandemic.
Patient Acceptability with Remote Pregnancy Monitoring
The results of thorough patient satisfaction studies highlight a strong preference for remote patient monitoring over hospital or clinic setups. For example, a comprehensive study on patient acceptability found that only 4.7% (6 out of 128) of participants preferred a hospital or clinic setup to remote patient monitoring. Moreover, 84% (107 out of 127) expressed being extremely content with the program. These outcomes and other findings show high levels of satisfaction (ranging from 87% to 100%), demonstrating that remote blood pressure monitoring programs for pregnancy are generally well-received.
Cost Savings with Remote Pregnancy Monitoring
One major benefit of remote pregnancy monitoring is cost savings. Remote blood pressure monitoring decreases hospital readmissions, shortens the length of hospital stays, and fewer medications and lab tests. A model by Niu and colleagues estimated a potential cost reduction of $93 per patient. If we apply this estimate to pregnant patients with hypertension (333,253) in the U.S. each year, telemedicine could save around $31 million in healthcare expenses annually.
Remote Patient Monitoring Devices For High-Risk Pregnancy
Each remote patient monitoring device measures a different vital sign. The device used depends on the patient’s condition. For example, a patient with gestational hypertension may benefit from using a blood pressure monitor. Conversely, a patient with gestational diabetes will benefit from using a blood glucose meter. It is important to note that the sophistication and availability of these devices vary based on the remote monitoring services provider.
Pregnancy-related remote monitoring devices may include:
- Weight scale: clinicians can quickly identify signs of heart failure and focus on early management.
- Blood pressure monitor: ensures blood pressure stays within a healthy range.
- Blood glucose meter: assess if a treatment plan works and adjust to optimize care.
Using FDA-cleared RPM devices at home can help obstetricians monitor patients more effectively and efficiently and reduce stress for at-risk patients. In addition, with adherence to HIPAA’s guidelines, patients can rest assured that all safeguards are in place to secure their personal information.
Find out more about the benefits of remote patient monitoring and how Tenovi remote health monitoring is better RPM experience for patients, physicians, and healthcare teams. Schedule a free demo and consultation today with Tenovi. No syncing. No apps. It just works—automatic and secure transmission of patient measurements within seconds.
