Overcoming Challenges of in Person Prenatal Care: A Pilot Study on the Usability and Acceptability of a Remote Monitoring Device for Pregnant Women in India

Abstract

Aim: Pregnancies considered high-risk, such as those with gestational diabetes (GDM), require continuous monitoring and special attention to properly manage maternal and fetal parameters. Personalized care is crucial for all pregnant women, particularly those residing in disadvantaged communities, to improve maternal and fetal outcomes. This study evaluated the feasibility and acceptability of the CareMother Fetosense digital, portable device for monitoring non-stress test/cardiotocography (NST/CTG) results remotely, with the aim of reaching the quality care to the last mile. Methodology: Six hospitals in Karnataka were included in this pilot study, and nine doctors were conveniently selected to participate. The doctors were provided with CareMother Fetosense devices to distribute among pregnant women, depending on their individual risk factors and observations. GDM patients in their last trimester (in the last 4-6 weeks of their pregnancy) were instructed to learn to use the device, download the app, and send the report. Total 305 pregnant women were surveyed using a close-ended questionnaire that covered questions about their characteristics, the outcomes of the fetal NST, and the women's perceptions of using the device. A descriptive analysis of the survey data was performed using STATA version 15.1. Results: The majority of the women were primigravida or first-time pregnant (54%), and the remaining 46% were multigravida. A major fraction of the NST results were reactive (89%), indicating that the fetal heart rate responded appropriately to fetal movements during the test. The majority of women diagnosed with GDM reported reactive results (n=37 out of 41). Overall, the women reported finding the usage of the Fetosense device simple, easy, and comfortable, with 99% of them having no issues. Conclusion: This device records fetal heartbeat and uterine contractions and sends real-time alerts to clinicians, allowing for efficient remote monitoring from anywhere. The findings of this study provided a sense of reassurance to pregnant women, and it eliminated the need for repeated visits and unnecessary anxiety. Such advanced healthcare solutions utilizing remote monitoring techniques have the potential to offer substantial cost-saving benefits, alleviate the burden for these women, and increase accessibility to healthcare services.