ICT N : Rijnstate Hospital monitors pregnant women at home using Sense4Baby

Pregnant women in the last phase of a high-risk pregnancy are monitored more closely, sometimes even with a daily CTG. These frequent trips to the hospital are not only very taxing for the women, but in times of the COVID pandemic this poses an extra risk. Therefore, the specialist Rijnstate Hospital opted for Sense4Baby, a system for telemonitoring that allows women to record a CTG themselves at home and transmit the data to the
hospital. How do patients feel about this care?

More than two thousand births take place in the specialist Rijnstate Hospital each year. Telemonitoring of pregnant women with a medical indication was already on the wish list of the hospital's Maternity Department. The outbreak of COVID-19 accelerated its implementation. The hospital made use of the offer by ICT Healthcare Technology Solutions (HTCS) to trial a number of Sense4Baby units for telemonitoring. This service is now a permanent feature of the care provided by the hospital.

Watch live or afterwards
Whereas women with a high-risk pregnancy normally travel to the hospital for a CTG, this care can now be offered safely and efficiently whilst the pregnant woman remains in her own familiar surroundings. She records a CTG herself at agreed times and sends the measurement values to the hospital via the Sense4Baby app on the smartphone provided with the equipment. There are two options: Option 1, the measurement data are transmitted at an agreed time and viewed later by the gynaecologist or a clinical midwife. Option 2, the hospital can view the remote
CTG live via the streamed data.

Stress caused by daily checks
One of the patients who opted for telemonitoring is Christina (36), who is pregnant with her fourth child. Her second child - a perfect baby girl - died in the womb at 36 weeks. A heart-rending tragedy. Therefore, Christina was monitored very closely during her third pregnancy. From the 35th week onwards she visited the Outpatients' Clinic at Rijnstate Hospital every day for a heart tracing of her and the baby. On the one hand, she was glad that she was being monitored so closely. 'But these daily trips to the hospital also caused a lot of stress', she explains. That stress is not good for the baby. Christina was also sleeping poorly as a result. For this reason, she was induced and her son was born at 38 weeks.

Practical, calm and intimate
In 2020, Christina was expecting her fourth child. Rijnstate Hospital had just started offering home monitoring to women with a high-risk pregnancy. Christina was given the opportunity to make use of this option. A fantastic solution, she explained. 'It's great that this is possible. The nervousness started increasing as I approached 36 weeks, as it did in the previous pregnancy. But now I do not need to travel to the hospital every day and I can record a CTG at home myself, just lying on my own couch or in my own bed. I am in contact with the hospital, but also with my child.' She already knows that she is having a girl. 'She is doing well, and we can wait patiently for her arrival', Christina calmly explains.

She feels confident that things will turn out well, because the Maternity Care team at Rijnstate Hospital is monitoring her closely. Every day, Christina attaches the toco and transducer to her belly using the elasticated belts and then connects the system using the included smartphone. The heart rate of mother and child, and contractions, if present, appear on the screen. She can also add notes if she experiences any pain, movement or something else. The hospital views the information remotely. 'If the heartbeat is too low or something is not right in the data they see, they call me immediately,' Christina explains. 'It is so good to know that I am being closely monitored, but that I can remain in my own familiar surroundings. It is practical, calm and intimate.'

What does the Sense4Baby unit consist of?
Sense4Baby is a mobile version of a CTG monitor. The product is supplied in a handy suitcase containing a transducer, a tocodynamometer, a
pulse oximeter, a smartphone that displays the measurement values and accessories such as chargers, gel and elasticated belts. This enables
pregnant women to record a CTG themselves. When they are given the suitcase, women receive instructions on how to perform a CTG and they can watch an instruction video in their own time at home. After attaching the elasticated belt, they can send the data via the smartphone to a portal in the cloud. If desired, the data can be transmitted from the cloud to the electronic patient dossier (EPD). Sense4Baby is so easy to use that it can also be explained to women who do not speak English.