Abstract
ObjectiveTo evaluate the feasibility of continuous telemetric trans-abdominal fetal electrocardiogram (a-fECG) in women undergoing labour induction at home.Study DesignLow risk women with singleton term pregnancy undergoing labour induction with retrievable, slow-release dinoprostone pessaries (n = 70) were allowed home for up to 24 hours, while a-fECG and uterine activity were monitored in hospital via wireless technology. Semi-structured diaries were analysed using a combined descriptive and interpretive approach.Results62/70 women (89%) had successful home monitoring; 8 women (11%) were recalled because of signal loss. Home monitoring lasted between 2–22 hours (median 10 hours). Good quality signal was achieved most of the time (86%, SD 10%). 3 women were recalled back to hospital for suspicious a-fECG. In 2 cases suspicious a-fECG persisted, requiring Caesarean section after recall to hospital. 48/51 women who returned the diary coped well (94%); 46/51 were satisfied with home monitoring (90%).ConclusionsContinuous telemetric trans-abdominal fetal ECG monitoring of ambulatory women undergoing labour induction is feasible and acceptable to women.
Highlights
The number of induced labours continues to increase with emerging evidence that induction of labour at term does not appear to increase caesarean delivery rates, but may benefit both mother and baby [1,2,3,4].Home induction has emerged as an increasingly popular alternative to labour induction in hospital settings [5,6]
There were 3 phases to this study: i) In-patient phase We recruited a total of 16 women in order to test the feasibility of the telemetric abdominal fetal electrocardiogram (a-fECG) monitoring device
The signal was transmitted through the a-fECG monitoring device to a standard hospital monitor (PC), via ordinary cell phone (Bluetooth technology) to an online data reception server, accessible to the hospital staff through the internet
Summary
The number of induced labours continues to increase with emerging evidence that induction of labour at term does not appear to increase caesarean delivery rates, but may benefit both mother and baby [1,2,3,4]. Home induction has emerged as an increasingly popular alternative to labour induction in hospital settings [5,6]. Safer alternatives to prostaglandins do not appear to be effective [7,8], and concerns for the fetal wellbeing during home inductions remain the key issue. Induction of labour is associated with decreased maternal satisfaction when compared with spontaneous labour [9]. Outpatient induction has been shown to increase maternal satisfaction; the home environment is private and familiar, increases control [10]
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