Your Pregnancy Matters
Online Ob/Gyn: How apps and remote devices can improve pregnancy care
February 25, 2020
More than 80% of people in the U.S. have smartphones, according to Pew Research Center. This abundance of connectivity offers new channels to connect patients with more convenient care and potentially improve their health after the baby comes.
While some aspects of Ob/Gyn care have to happen in person, more providers are offering check-ups through connected devices. So, it was no surprise that telemedicine – providing health care via connected devices – was a hot topic at this year’s Society for Maternal-Fetal Medicine (SMFM) annual meeting in Grapevine.
Many Ob/Gyn teams presented studies focused on apps and remote monitoring for specific conditions. Let's take a closer look at a few of the trends and findings, as well as what to expect in the near future from remote Ob/Gyn care.
Studies on app use during pregnancy
One study examined how women felt about using mobile apps as part of their pregnancy care. Researchers interviewed patients about their preferences and what they felt was most helpful.
Tracking the baby's development between ultrasounds topped the list. Apps already exist to provide general estimates of in-utero milestones and fetal size. However, most apps are for reference only and don't include the option to interface with a provider.
Respondents also wanted convenient access to reliable health information. It makes sense – for example, an app connected to a drug database could help patients choose safe cold medications or allergy remedies to take while pregnant or breastfeeding.
Another perk of pregnancy-related apps? Support and camaraderie from other users. Virtual communities can offer empathy and tips for managing pregnancy symptoms like trouble sleeping or weird food cravings.
But apps weren't the sole focus. Several studies examined the effectiveness of remote monitoring – gathering patients' self-supplied data without an office visit – during and after pregnancy.
Studies on remote monitoring
Two remote monitoring topics stuck out to me as potentially beneficial, based on many of the questions I get from patients: managing weight gain during pregnancy and postpartum follow-up for women who had high blood pressure (preeclampsia) during pregnancy.
Managing pregnancy weight gain
A study found that excessive weight gain could be curbed with remote monitoring.
Patients in the study were provided with a digital scale that reported their weight to a provider. These patients were found to gain less excessive weight during pregnancy – and retain less of that weight after – than women who did not have remote weight monitoring.
Postpartum follow-up for preeclampsia
High blood pressure during pregnancy (and after delivery) puts patients at risk for serious health issues, including blood clots, heart attacks, or strokes. Follow-up after delivery is critical in reducing these risks after leaving the hospital, as well as potential heart problems in the future.
But it's tough to get to the doctor's office to check your blood pressure with a new baby in tow. One study from the conference found that text reminders to women with high blood pressure 12 months after delivery did not improve follow-up rates.
Results from another study suggest that remote monitoring could solve both issues. One set of patients with high blood pressure was sent home with instructions to check their blood pressure twice a day with a standard cuff and record their numbers in a log to share later with a nurse.
A second set went home with similar instructions, but instead of using a log, their blood pressure numbers were automatically tracked using a blood pressure cuff remotely connected to a nurse.
No patients in the log group followed the recommendations. But surprisingly, nearly two-thirds of the remote monitoring group complied. The disparity might have to do with accountability – the second group knew a nurse would immediately receive their results. Or perhaps it was because remote monitoring requires fewer steps. Regardless, that's a big gap!
Understanding ultrasound: The head-to-toe tour
Dr. Robyn Horsager-Boehrer explains step-by-step what obstetricians are looking for when they conduct 18- to 20-week ultrasounds on pregnant women. You'll see as they check for birth defects such as Down syndrome and spina bifida.
The future of device-based Ob/Gyn care
The convenience of apps and remote monitoring are excellent perks, and the initial data are promising. However, the key to success with these technologies will be forming collaborative partnerships between patients and providers.
There's an element of trust that must occur when patients are tasked with providing their own data. The patient must believe the provider has their best interests at heart. At the same time, the provider must be able to trust that the patient will provide accurate data and do their best to follow recommendations. Device-based care could also increase accountability in the provider-patient relationship and open the door for more personalized care.
If the buzz at the SMFM conference was any indication, I expect to see an increase in health care app and device development in the next few years. It’s encouraging to see the medical community get excited about exploring new channels to meet specific medical needs of pregnant patients.