Low-risk antenatal care enhanced by telemedicine: a practical guideline model

Article type
Authors
Colombo T1, Stein A2, Cazella S2, Soares Rech R2, Cordeiro Gabriel F2, Vargas Alves R
1Universidade Federal de Ciências da Saúde de Porto Alegre - UFCSPA, Porto Alegre, RS, Brasil; Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brasil
2Universidade Federal de Ciências da Saúde de Porto Alegre - UFCSPA, Porto Alegre, RS, Brasil
Abstract
Objective: To develop a protocol for hybrid low-risk prenatal care, merging reduced face-to-face consultations and remote monitoring, adapted to Brazilian guidelines. Methods: PubMed, Embase, and Cochrane Library were systematically searched on telemedicine and antenatal care perspectives and adaptation of the Low-Risk Prenatal Care protocols recommended by the Ministry of Health and the Brazilian Federation of Gynecology and Obstetrics Associations. Results: Five relevant articles and three manuals were included in the review for the presented criteria to develop this clinical guideline. This study identifies that the consultation schedule is unevenly distributed among the gestational trimesters and ranges from 7 to 14 appointments. The authors generally propose one to two appointments in the first trimester, two to three in the second trimester, and two to six in the third trimester. Only three studies included puerperal evaluations. The routine exams recommended show minimal variations among authors. To date, there are no validated Brazilian protocols for prenatal care by telemedicine. The studies included showed that the satisfaction of pregnant women regarding this form of care and the outcomes of interest, except for hypertensive diseases, were similar between the groups exposed to traditional prenatal care and hybrid prenatal care. Conclusion: The current guideline comprises the Ministry of Health recommendations for low-risk prenatal care, reducing exposure to the hospital environment and decreasing costs. A randomized clinical trial protocol, which the research group had developed, will provide information on this issue's safety, effectiveness, satisfaction, and costs.