Pazart L, Blondel B, Breart G, Durieux P; International Society of Technology Assessment in Health Care. Meeting.
Abstr Int Soc Technol Assess Health Care Meet. 1993; 9: 131.
Agence Nationale pour le Developpement de l'Evaluation Medicale (ANDEM), Paris, France.
INTRODUCTION. Antenatal surveillance of women with a so-called "high risk8 pregnancy is largely based on foetal heart rate monitoring (FHRM) and frequently requires admission to hospital. Foetal telemonitoring (FTM) is a method of foetal heart rate monitoring by telephone. The patient records her foetus's heart rate herself, at home, and then connects the machine to her telephone and sends the recording obtained to the maternity unit. OBJECTIVE. The evaluation conducted by ANDEM was designed to determine if FTM could decrease the rate of admission to hospital with outcome of pregnancy similar to that achieved in inpatient ward. METHOD. An analysis of the literature was performed by interrogating MEDLINE, EXCERPTA MEDICA, BIOSIS and PASCAL and systematic review of 9 major journals. The Oxford Database on Perinatal Trials was also consulted and manufacturers were contacted. Lastly, a postal survey was conducted amongst the 612 members of the French National College of Gynaecologists and Obstetricians concerning medical practice and opinion on FHRM and FTM (79% response rate). All the information was synthetized and then discussed by a multidisciplinary group of experts in order to review the state of the technique and to make recommendations. RESULTS. 61 papers concerning FTM were identified, two of which reported a randomised controlled study, one reported a non-randomised controlled study and 14 papers reported 10 series. The group of experts considered that the data collected concerning FTM were not sufficient to demonstrate a reduction in the number or duration of hospitalisations when women who would normally be admitted to hospital were monitored by FTM. The postal survey indicated that 15.4% of the obstetricians already used FTM, despite the fact that the telemonitor has not yet got its premarked approval. 63% of non-users of FTM indicated that they were ready to prescribe FTM. Telemonitoring raises also problems of transmission and confidentiality, and questions concerning the sharing of responsibilities between the patient and the nursing staff. CONCLUSION. The widespread use of FTM should not be considered without prior evaluation of its efficacy and safety according to a clinical experimental protocol combined with an economic analysis.
Publication Types:
Keywords:
- Data Collection
- Female
- Hospitalization
- Humans
- Monitoring, Physiologic
- Pregnancy
- Prenatal Care
- Research Design
- Risk Management
- Telephone
- economics
- epidemiology
- methods
- hsrmtgs
Other ID:
UI: 102211515
From Meeting Abstracts