Positive experience of introducing telemedicine technologies in the Ekaterinburg Clinical Perinatal Centre

Abstract

Introduction A clinical and statistical analysis of the medical records of the first obstetric hospital of the Ekaterinburg Clinical Perinatal Centre (ECPC) was performed to assess the medical effectiveness of the integration of telemedicine technology (TMT) into the system of medical care in the case of threatened and preterm birth (PB).The aim of the work was to assess the medical effectiveness of integrating a range of telemedicine technologies into the system of medical care in the case of threatened and preterm birth as exemplified by the ECPC (First Obstetric Hospital).Materials and methods Preterm births between 22 and 36 weeks and 6 days of gestation were selected for the study. The number of PBs was 2,468 before the introduction of telemedicine technology and 2,112 after the introduction of telemedicine technology. The incidence of extremely low birth weight was analyzed to assess the impact of TMT implementation on neonatal outcomes. Criterion of Kolmogorov – Smirnov was applied to assess the normality of the distribution; to analyse the difference between groups – criterion of Kruskal – Wallis for K-independent samples. The arithmetic mean, standard error and standard deviation were calculated. Significance of differences between the averages was assessed using Student’s t-test.Results Before the introduction of TMT, no significant difference was found in the proportion of PB groups between different years and the structure of PP did not change according to gestational age. After the introduction of TMT there was also no significant difference in the pattern of PB. The proportion of extremely early PB before TMT implementation was significantly higher than after implementation. There was a significant decrease in the number of preterm infants with extremely low birth weight after implementation compared with the period before TMT.Discussion The use of automated systems implemented in the Sverdlovsk region, which are applications for mobile phones or personal computers, does not require the financial investment associated with the purchase of additional expensive equipment by pregnant women. Like the authors of earlier studies, we note a prolongation of gestational age and a reduction in the frequency of extremely low birth weight babies.Conclusion The incidence of extremely early PB decreased from 10.81 % to 7.13 % (p = 0.012) during 2016–2021, the incidence of late PB increased from 54.6 % to 60.1 % (p = 0.027) due to increasing gestational age. The number of babies born with extremely low birth weight decreased from 13.69 % to 8.36 % (p ≤ 0.001).