9 van den Heuvel et al reported 12 studies on the use of telemonitoring and teleconsulting interventions to improve pregnancy care generally. 9 The included studies showed positive results in the improvement of maternal health and acceptability of solutions, although most of the studies involved a small number of participants, and none were complete clinical studies. 8 Rivera-Romero et al captured only 11 studies conducted in high-income countries, on mHealth interventions for the hypertensive disorder of pregnancy. When only studies with low risk of bias were considered, the added value of telemonitoring became less pronounced. In addition, the included studies had a high methodological risk of bias. 8 This review, however, used a narrow time range and focused on telemonitoring solutions implemented in high-income countries for pregnant women at high risk for gestational diabetes and preterm labour. 6 Lanssens et al reported 14 studies from 1988 to 2010 that used telemonitoring interventions for pregnant women during the prenatal period.

The review also primarily identified studies from high-income countries like the UK, USA and Belgium. 6 However, the review mainly focused on telemonitoring interventions for remote blood pressure monitoring of pregnant women. Aquino et al reported 16 unique, feasible and cost-effective telemonitoring interventions to support pregnant women with hypertensive disorder of pregnancy. To date, four reviews explored the use of digital tools for remote monitoring of pregnant women at HRPE/E. 7ĭigital health interventions (DHIs) are increasingly being used to support pregnant women at HRPE/E for remote monitoring of blood pressure and symptoms. WHO suggests home blood pressure monitoring for pregnant women at HRPE/E to detect changes in blood pressure between antenatal visits and to ensure care continuity. 4–6 Self-monitoring also has a role in preventing conditions like white coat hypertension and masked hypertension in pregnant women at HRPE/E. 1 International guidelines including the European Society of Hypertension, American Heart Association, National Institute for Health and Care Excellence (NICE), and American Society of Hypertension guidelines, recommend self-monitoring for PE symptoms and recording of blood pressure for pregnant women at high risk for PE/E (HRPE/E) because of their potential benefits such as effective control of blood pressure, early risk identification, and treatment, and cost savings due to fewer hospital visits. The most effective strategies to ensure early diagnosis and management of PE/E include self-monitoring of blood pressure, use of magnesium sulfate therapy, proteinuria determinations and timely delivery. 2 To meet the United Nations Sustainable Developmental Goal target 3.1 of reducing the maternal mortality ratio to less than 70/100 000 live births by 2030, innovations are required to decrease PE/E-related mortality. 1 High maternal mortality from PE/E results from: (1) lack of early identification and treatment of pregnant women, (2) difficulties in reaching treatment centres and (3) poor health-seeking behaviours linked with low patient education. The review reported three major outcomes: maternal health outcomes including maternal and neonatal morbidity and mortality (n=4) usability and acceptability including ease-of-use, and perceived usefulness, (n=5) and intervention feasibility and fidelity including accuracy of device, and intervention implementation (n=7).Īpproximately 16% of all maternal deaths in low-income and middle-income countries (LMICs) are attributable to pre-eclampsia/eclampsia (PE/E). The review identified key functions of interventions including data collection, prediction of adverse maternal outcomes, integrated diagnostic and clinical decision support, and personal health tracking. Both of these purposes used mobile phone applications as interface to facilitate data collection, decision making, and communication between health workers and pregnant women. Of nine unique digital health interventions, two served the purpose of predicting risk for adverse maternal health outcomes while seven focused on monitoring high-risk pregnant women for PE/E. Most studies were conducted in South Asia and sub-Saharan Africa (n=16).

Results A total of 19 publications describing 7 unique studies and 9 different digital health interventions were included.

Ease diagnostics review