Mobile Health Applications for Prenatal Assessment and Monitoring

Author(s): Wilfried Gyselaers*, Dorien Lanssens, Helen Perry, Asma Khalil

Journal Name: Current Pharmaceutical Design

Volume 25 , Issue 5 , 2019

Become EABM
Become Reviewer
Call for Editor


Background: A mobile health application is an exciting, fast-paced domain that is likely to improve prenatal care.

Methods: In this narrative review, we summarise the use of mobile health applications in this setting with a special emphasis on both the benefits of remote monitoring devices and the potential pitfalls of their use, highlighting the need for robust regulations and guidelines before their widespread introduction into prenatal care.

Results: Remote monitoring devices for four areas of prenatal care are reported: (1) cardio-tocography; (2) blood glucose levels; (3) blood pressure; and (4) prenatal ultrasound. The majority of publications are pilot projects on remote consultation, education, coaching, screening, monitoring and selective booking, mostly reporting potential medical and/or economic benefits by mobile health applications over conventional care for very specific situations, indications and locations, but not always generalizable.

Conclusions: Despite the potential advantages of these devices, some caution must be taken when implementing this technology into routine daily practice. To date, the majority of published research on mobile health in the prenatal setting consists of observational studies and there is a need for high-quality randomized controlled trials to confirm the reported clinical and economic benefits as well as the safety of this technology. There is also a need for guidance and governance on the development and validation of new apps and devices and for the implementation of mobile health technology into healthcare systems in both high and low-income settings. Finally, digital communication technologies offer perspectives towards exploration and development of the very new domain of tele-pharmacology.

Keywords: mhealth, remote monitoring, telehealth, mobile health applications, prenatal care, maternal outcomes, neonatal outcomes.

Tagliaferri S, Esposito FG, Ippolito A, et al. Telemedicine to Improve Access to Specialist Care in Fetal Heart Rate Monitoring: Analysis of 17 Years of TOCOMAT Network Clinical Activity. Telemed J E Health 2017; 23(3): 226-32.
Amoah B, Anto EA, Osei PK, Pieterson K, Crimi A. Boosting antenatal care attendance and number of hospital deliveries among pregnant women in rural communities: A community initiative in Ghana based on mobile phones applications and portable ultrasound scans. BMC Pregnancy Childbirth 2016; 16(1): 141.
Magann EF, McKelvey SS, Hitt WC, Smith MV, Azam GA, Lowery CL. The use of telemedicine in obstetrics: A review of the literature. Obstet Gynecol Surv 2011; 66(3): 170-8.
Morris DG. Using telemedicine to facilitate training in cardiotocography (CTG) interpretation. J Telemed Telecare 2000; 6(Suppl. 1): S53-5.
Xi H, Gan G, Zhang H, Chen C. Design of smart care tele-monitoring system for mother and fetus. Zhongguo Yi Liao Qi Xie Za Zhi 2015; 39(2): 102-4.
Chourasia VS, Tiwari AK. Implementation of foetal e-health monitoring system through biotelemetry. Int J Electron Healthc 2012; 7(1): 36-52.
Fanelli A, Signorini MG, Ferrario M, et al. Telefetalcare: A first prototype of a wearable fetal electrocardiograph. In: Conference proceedings : Annual International Conference of the IEEE Engineering in Medicine and Biology Society IEEE Engineering in Medicine and Biology Society Annual Conference 2011. 2011; 6899-902.
Fanelli A, Ferrario M, Piccini L, et al. Prototype of a wearable system for remote fetal monitoring during pregnancy. In: Conference proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society IEEE Engineering in Medicine and Biology Society Annual Conference . 2010; 5815-8.
Hod M, Kerner R. Telemedicine for antenatal surveillance of high-risk pregnancies with ambulatory and home fetal heart rate monitoring--an update. J Perinat Med 2003; 31(3): 195-200.
Su CJ, Chu TW. A mobile multi-agent information system for ubiquitous fetal monitoring. Int J Environ Res Public Health 2014; 11(1): 600-25.
van den Heuvel JF, Groenhof TK, Veerbeek JH, et al. eHealth as the Next-Generation Perinatal Care: An Overview of the Literature. J Med Internet Res 2018; 20(6): e202.
Lanssens D, Vandenberk T, Thijs IM, Grieten L, Gyselaers W. Effectiveness of telemonitoring in obstetrics: Scoping review. J Med Internet Res 2017; 19(9): e327.
Urquhart C, Currell R, Harlow F, Callow L. Home uterine monitoring for detecting preterm labour. Cochrane Database Syst Rev 2017; 2: CD006172.
Tõrõk M, Turi Z, Kovács F. Ten years’ clinical experience with telemedicine in prenatal care in Hungary. J Telemed Telecare 1999; 5(Suppl. 1): S14-7.
Zhang P, Dong L, Chen H, Chai Y, Liu J. The Rise and Need for Mobile Apps for Maternal and Child Health Care in China: Survey Based on App Markets. JMIR Mhealth Uhealth 2018; 6(6): e140.
Mertz L. Ultrasound? Fetal monitoring? Spectrometer? There’s an app for that!: biomedical smart phone apps are taking healthcare by storm. IEEE Pulse 2012; 3(2): 16-21.
Kovács F, Fodor G, Hosszú G. A proposed novel method for CHD screening by fetal heart murmur detection using phonocardiography. Stud Health Technol Inform 2013; 186: 160-4.
Vermeulen-Giovagnoli B, Peters C, van der Hout-van der Jagt MB, et al. The development of an obstetric tele-monitoring system. In: Conference proceedings : Annual International Conference of the IEEE Engineering in Medicine and Biology Society IEEE Engineering in Medicine and Biology Society Annual Conference. 2015; 177-80.
O’Brien E, Rauf Z, Alfirevic Z, Lavender T. Women’s experiences of outpatient induction of labour with remote continuous monitoring. Midwifery 2013; 29(4): 325-31.
Pan J, Lu Y, Pan L, et al. Value of long-distance fetal heart rate monitoring on the pre-partum health care of the pregnant woman with umbilical cord loops. Zhonghua Fu Chan Ke Za Zhi 2002; 37(8): 451-4.
Dawson A, Cohen D, Candelier C, et al. Domiciliary midwifery support in high-risk pregnancy incorporating telephonic fetal heart rate monitoring: A health technology randomized assessment. J Telemed Telecare 1999; 5(4): 220-30.
Yang P, Lo W, He ZL, Xiao XM. Medical nutrition treatment of women with gestational diabetes mellitus by a telemedicine system based on smartphones. J Obstet Gynaecol Res 2018; 44(7): 1228-34.
Dalfrà MG, Nicolucci A, Lapolla A. The effect of telemedicine on outcome and quality of life in pregnant women with diabetes. J Telemed Telecare 2009; 15(5): 238-42.
Rasekaba TM, Furler J, Blackberry I, Tacey M, Gray K, Lim K. Telemedicine interventions for gestational diabetes mellitus: A systematic review and meta-analysis. Diabetes Res Clin Pract 2015; 110(1): 1-9.
Ming WK, Mackillop LH, Farmer AJ, et al. Telemedicine technologies for diabetes in pregnancy: A Systematic Review and Meta-Analysis. J Med Internet Res 2016; 18(11): e290.
Mougiakakou S, Stoitsis J, Iliopoulou D, Prentza A, Nikita K, Koutsouris D. A Communication Platform for Tele-monitoring and Tele-management of Type 1 Diabetes In: Conference proceedings : Annual International Conference of the IEEE Engineering in Medicine and Biology Society IEEE Engineering in Medicine and Biology Society Annual Conference; 2005; 2207-10.
Chilelli NC, Dalfrà MG, Lapolla A. The emerging role of telemedicine in managing glycemic control and psychobehavioral aspects of pregnancy complicated by diabetes. Int J Telemed Appl 2014; 2014: 621384.
Nudell J, Slade A, Jovanovič L, Hod M. Technology and pregnancy. Int J Clin Pract Suppl 2011; (170): 55-60.
Kalafat E, Mir I, Perry H. Is home blood-pressure monitoring in hypertensive disorders of pregnancy consistent with clinic recordings? Ultrasound Obstet Gynecol 2018; 52(4): 515-21.
Perry H, Sheehan E, Thilaganathan B, Khalil A. Home blood-pressure monitoring in a hypertensive pregnant population. Ultrasound Obstet Gynecol 2018; 51(4): 524-30.
Lanssens D, Vandenberk T, Smeets CJ, et al. Remote Monitoring of Hypertension Diseases in Pregnancy: A Pilot Study. JMIR Mhealth Uhealth 2017; 5(3): e25.
Lanssens D, Vonck S, Storms V, Thijs IM, Grieten L, Gyselaers W. The impact of a remote monitoring program on the prenatal follow-up of women with gestational hypertensive disorders. Eur J Obstet Gynecol Reprod Biol 2018; 223: 72-8.
Brown J, Holland B. Successful Fetal Tele-Echo at a Small Regional Hospital. Telemed J E Health 2017; 23(6): 485-92.
Soong B, Chan FY, Bloomfield S, Smith M, Watson D. The fetal tele-ultrasound project in Queensland. Aust Health Rev 2002; 25(3): 67-73.
Ferrer-Roca O, Kurjak A, Mario Troyano-Luque J, Bajo Arenas J, Luis Mercé A, Diaz-Cardama A. Tele-virtual sonography. J Perinat Med 2006; 34(2): 123-9.
Kratochwil A, Lee A, Schoisswohl A. Networking of three dimensional sonography volume data. Ultrasound Obstet Gynecol 2000; 16(4): 335-40.
Ferlin RM, Vaz-Oliani DM, Ferreira AC, Tristão EG, Oliani AH. Tele-obstetric ultrasound: Analysis of first-trimester ultrasound images transmitted in realtime. J Telemed Telecare 2012; 18(1): 54-8.
Chan FY, Whitehall J, Hayes L, et al. Minimum requirements for remote realtime fetal tele-ultrasound consultation. J Telemed Telecare 1999; 5(3): 171-6.
Chan FY, Soong B, Watson D, Whitehall J. Realtime fetal ultrasound by telemedicine in Queensland. A successful venture? J Telemed Telecare 2001; 7(Suppl. 2): 7-11.
Scali MC, de Azevedo Bellagamba CC, Ciampi Q, et al. Stress echocardiography with smartphone: real-time remote reading for regional wall motion. Int J Cardiovasc Imaging 2017; 33(11): 1731-6.
Mirabel M, Celermajer D, Beraud AS, Jouven X, Marijon E, Hagège AA. Pocket-sized focused cardiac ultrasound: strengths and limitations. Arch Cardiovasc Dis 2015; 108(3): 197-205.
Huang CC, Lee PY, Chen PY, Liu TY. Design and implementation of a smartphone-based portable ultrasound pulsed-wave Doppler device for blood flow measurement. IEEE Trans Ultrason Ferroelectr Freq Control 2012; 59(1): 182-8.
Arbeille P, Zuj K, Saccomandi A, et al. Teleoperated Echograph and Probe Transducer for Remote Ultrasound Investigation on Isolated Patients (Study of 100 Cases). Telemed J E Health 2016; 22(7): 599-607.
Arbeille P, Ayoub J, Kieffer V, et al. Abdominal and fetal echography tele-operated in several medical centres sites, from an expert center, using a robotic arm & telephone or satellite link. J Gravit Physiol 2007; 14(1): 139-40.
Arbeille P, Ruiz J, Herve P, Chevillot M, Poisson G, Perrotin F. Fetal tele-echography using a robotic arm and a satellite link. Ultrasound Obstet Gynecol 2005; 26(3): 221-6.
Chan FY. Fetal tele-ultrasound and tele-therapy. J Telemed Telecare 2007; 13(4): 167-71.
Dalewyn L, Deschepper E, Gerris J. Correlation between follicle dimensions recorded by patients at home (SOET) versus ultrasound performed by professional care providers. Facts Views Vis ObGyn 2017; 9(3): 153-6.
Thorup TJ, Zingenberg H. Use of ‘non-medical’ ultrasound imaging before mid-pregnancy in Copenhagen. Acta Obstet Gynecol Scand 2015; 94(1): 102-5.
Wu AR, Fouzdar-Jain S, Suh DW. Comparison study of funduscopic examination using a smartphone-based digital ophthalmoscope and the direct ophthalmoscope. J Pediatr Ophthalmol Strabismus 2018; 55(3): 201-6.
Shah P, Yauney G, Gupta O, et al. Technology-enabled examinations of cardiac rhythm, optic nerve, oral health, tympanic membrane, gait and coordination evaluated jointly with routine health screenings: An observational study at the 2015 Kumbh Mela in India. BMJ Open 2018; 8(4): e018774.
Wicks LC, Cairns GS. EnLightenment: High resolution smartphone microscopy as an educational and public engagement platform. Wellcome Open Res 2017; 2: 107.
Gerris J. Telemonitoring in IVF/ICSI. Curr Opin Obstet Gynecol 2017; 29(3): 160-7.
Mangwi Ayiasi R, Atuyambe LM, Kiguli J, Garimoi Orach C, Kolsteren P, Criel B. Use of mobile phone consultations during home visits by community health workers for maternal and newborn care: community experiences from masindi and kiryandongo districts, uganda. BMC Public Health 2015; 15: 560.
Friesen CA, Hormuth LJ, Petersen D, Babbitt T. Using videoconferencing technology to provide breastfeeding support to low-income women: Connecting hospital-based lactation consultants with clients receiving care at a community health center. J Hum Lact 2015; 31(4): 595-9.
Hishitani T, Fujimoto Y, Saito Y, Sugamoto K, Hoshino K, Ogawa K. A medical link between local maternity hospitals and a tertiary center using telediagnosis with fetal cardiac ultrasound image transmission. Pediatr Cardiol 2014; 35(4): 652-7.
Sharma S, Parness IA, Kamenir SA, et al. Screening fetal echocardiography by telemedicine: efficacy and community acceptance. J Am Soc Echocardiogr 2003; 16(3): 202-8.
Viñals F, Mandujano L, Vargas G, Giuliano A. Prenatal diagnosis of congenital heart disease using four-dimensional spatio-temporal image correlation (STIC) telemedicine via an Internet link: A pilot study. Ultrasound Obstet Gynecol 2005; 25(1): 25-31.
Norum J, Bergmo TS, Holdø B, et al. A tele-obstetric broadband service including ultrasound, videoconferencing and cardiotocogram. A high cost and a low volume of patients. J Telemed Telecare 2007; 13(4): 180-4.
Rabie NZ, Canon S, Patel A, Zamilpa I, Magann EF, Higley J. Prenatal diagnosis and telemedicine consultation of fetal urologic disorders. J Telemed Telecare 2016; 22(4): 234-7.
Morris DG, Hayward T. Enhancement of an antenatal diagnosis and counselling service (ADACS) through the ready availability of telemedicine services. J Telemed Telecare 2000; 6(Suppl. 1): S56-8.
Smith P, Brebner E. Tele-ultrasound for remote areas. J Telemed Telecare 2002; 8(Suppl. 2): 80-1.
Bronstein JM, Ounpraseuth S, Jonkman J, et al. Use of specialty OB consults during high-risk pregnancies in a Medicaid-covered population: initial impact of the Arkansas ANGELS intervention. Med Care Res Rev 2012; 69(6): 699-720.
Adriaanse BM, Tromp CH, Simpson JM, et al. Interobserver agreement in detailed prenatal diagnosis of congenital heart disease by telemedicine using four-dimensional ultrasound with spatiotemporal image correlation. Ultrasound Obstet Gynecol 2012; 39(2): 203-9.
Pflugeisen BM, McCarren C, Poore S, Carlile M, Schroeder R. Virtual Visits: Managing prenatal care with modern technology. MCN Am J Matern Child Nurs 2016; 41(1): 24-30.
Mankuta D, Vinker S, Shapira S, Laufer N, Shveiky D. The use of a perinatal internet consultation forum in Israel. BJOG 2007; 114(1): 108-10.
Weissman SM, Zellmer K, Gill N, Wham D. Implementing a Virtual Health Telemedicine Program in a Community Setting. J Genet Couns 2018; 27(2): 323-5.
Skjøth MM, Hansen HP, Draborg E, Pedersen CD, Lamont RF, Jørgensen JS. Informed choice for participation in down syndrome screening: Development and content of a web-based decision aid. JMIR Res Protoc 2015; 4(3): e113.
Abrams DJ, Geier MR. A comparison of patient satisfaction with telehealth and on-site consultations: A pilot study for prenatal genetic counseling. J Genet Couns 2006; 15(3): 199-205.
Roberts S, Birgisson N, Julia Chang D, Koopman C. A pilot study on mobile phones as a means to access maternal health education in eastern rural Uganda. J Telemed Telecare 2015; 21(1): 14-7.
Di Lieto A, Scaramellino M, Campanile M, et al. [Prenatal telemedicine and teledidactic networking. A report on the TOCOMAT project] Minerva Ginecol 2002; 54(5): 447-51.
Johnsen H, Blom KF, Lee A, Nørgaard B. Using ehealth to increase autonomy supportive care: A multicenter intervention study in antenatal care. Comput Inform Nurs 2018; 36(2): 77-83.
Mackert M, Guadagno M, Donovan E, Whitten P. Including men in prenatal health: the potential of e-health to improve birth outcomes. Telemed J E Health 2015; 21(3): 207-12.
Abbass-Dick J, Xie F, Koroluk J, et al. The Development and piloting of an eHealth breastfeeding resource targeting fathers and partners as co-parents. Midwifery 2017; 50: 139-47.
Mackert M, Guadagno M, Lazard A, et al. Engaging men in prenatal health promotion: A pilot evaluation of targeted e-health content. Am J Men Health 2017; 11(3): 719-25.
Abroms LC, Chiang S, Macherelli L, Leavitt L, Montgomery M. Assessing the National Cancer Institute’s SmokefreeMOM text-messaging program for pregnant smokers: Pilot randomized trial. J Med Internet Res 2017; 19(10): e333.
Mauriello LM, Van Marter DF, Umanzor CD, Castle PH, de Aguiar EL. Using mHealth to deliver behavior change interventions within prenatal care at community health centers. Am J Health Promot 2016; 30(7): 554-62.
Evans WD, Wallace Bihm J, Szekely D, et al. Initial outcomes from a 4-week follow-up study of the Text4baby program in the military women’s population: randomized controlled trial. J Med Internet Res 2014; 16(5): e131.
Bogaerts A, Ameye L, Bijlholt M, Amuli K, Heynickx D, Devlieger R. INTER-ACT: prevention of pregnancy complications through an e-health driven interpregnancy lifestyle intervention - study protocol of a multicentre randomised controlled trial. BMC Pregnancy Childbirth 2017; 17(1): 154.
Kennelly MA, Ainscough K, Lindsay K, Gibney E, Mc Carthy M, McAuliffe FM. Pregnancy, exercise and nutrition research study with smart phone app support (Pears): Study protocol of a randomized controlled trial. Contemp Clin Trials 2016; 46: 92-9.
van der Wulp NY, Hoving C, Eijmael K, Candel MJ, van Dalen W, De Vries H. Reducing alcohol use during pregnancy via health counseling by midwives and internet-based computer-tailored feedback: A cluster randomized trial. J Med Internet Res 2014; 16(12): e274.
van Dijk MR, Oostingh EC, Koster MP, Willemsen SP, Laven JS, Steegers-Theunissen RP. The use of the mHealth program Smarter Pregnancy in preconception care: Rationale, study design and data collection of a randomized controlled trial. BMC Pregnancy Childbirth 2017; 17(1): 46.
Kolbe N, Killu K, Coba V, et al. Point of care ultrasound (POCUS) telemedicine project in rural Nicaragua and its impact on patient management. J Ultrasound 2014; 18(2): 179-85.
Long MC, Angtuaco T, Lowery C. Ultrasound in telemedicine: Its impact in high-risk obstetric health care delivery. Ultrasound Q 2014; 30(3): 167-72.
Kovacs F, Torok M, Horvath C, et al. A new, phonocardiography-based telemetric fetal home monitoring system. Telemed J E Health 2010; 16(8): 878-2.
Di Lieto A, De Falco M, Campanile M, et al. Regional and international prenatal telemedicine network for computerized antepartum cardiotocography. Telemed J E Health 2008; 14(1): 49-54.
Di Lieto A, De Falco M, Campanile M, et al. Four years’ experience with antepartum cardiotocography using telemedicine. J Telemed Telecare 2006; 12(5): 228-33.
Di Lieto A, Giani U, Campanile M, De Falco M, Scaramellino M, Papa R. Prenatal telemedicine: clinical experience with conventional and computerised antepartum telecardiotocography. Eur J Obstet Gynecol Reprod Biol 2002; 103(2): 114-8.
Pan J, Ye M, Du X. [Clinical experience of long-distance electronic fetal heart rate monitoring system by telephone]. Zhonghua Fu Chan Ke Za Zhi 2000; 35(1): 14-6.
Di Lieto A, Catalano D, Pontillo M, et al. Telecardiotocography in prenatal telemedicine. J Telemed Telecare 2001; 7(2): 119-20.
Ferrara A, Hedderson MM, Ching J, Kim C, Peng T, Crites YM. Referral to telephonic nurse management improves outcomes in women with gestational diabetes. Am J Obstet Gynecol 2012; 206(6): 491.e1-5.
Homko CJ, Deeb LC, Rohrbacher K, et al. Impact of a telemedicine system with automated reminders on outcomes in women with gestational diabetes mellitus. Diabetes Technol Ther 2012; 14(7): 624-9.
Homko CJ, Santamore WP, Whiteman V, et al. Use of an internet-based telemedicine system to manage underserved women with gestational diabetes mellitus. Diabetes Technol Ther 2007; 9(3): 297-306.
Lanssens D, Vandenberk T, Smeets CJ, et al. Remote monitoring of hypertension diseases in pregnancy: A pilot study. JMIR Mhealth Uhealth 2017; 5(3): e25.
Lanssens D, Vonck S, Storms V, Thijs IM, Grieten L, Gyselaers W. The impact of a remote monitoring program on the prenatal follow-up of women with gestational hypertensive disorders. Eur J Obstet Gynecol Reprod Biol 2018; 223: 72-8.
Hirshberg A, Downes K, Srinivas S. Comparing standard office-based follow-up with text-based remote monitoring in the management of postpartum hypertension: A randomised clinical trial. BMJ Qual Saf 2018; 27(11): 871-7.
Rhoads SJ, Serrano CI, Lynch CE, et al. Exploring Implementation of m-Health Monitoring in Postpartum Women with Hypertension. Telemed J E Health 2017; 23(10): 833-41.
Ivey TL, Hughes D, Dajani NK, Magann EF. Antenatal management of at-risk pregnancies from a distance. Aust N Z J Obstet Gynaecol 2015; 55(1): 87-9.
Wood D. STORC helps deliver healthy babies: The telemedicine program that serves rural women with high-risk pregnancies. Telemed J E Health 2011; 17(1): 2-4.
Middeke M. [Hypertensive Disorders in Pregnancy]. Deutsche medizinische Wochenschrift (1946) 2016; 141(18): 1287-94.
Zairina E, Abramson MJ, McDonald CF, et al. Telehealth to improve asthma control in pregnancy: A randomized controlled trial. Respirology 2016; 21(5): 867-74.
Parisi F, Rousian M, Koning AH, Willemsen SP, Cetin I, Steegers-Theunissen RP. Periconceptional maternal one-carbon biomarkers are associated with embryonic development according to the Carnegie stages. Hum Reprod 2017; 32(3): 523-30.
Dryden-Peterson S, Bennett K, Hughes MD, et al. An augmented SMS intervention to improve access to antenatal CD4 testing and ART initiation in HIV-infected pregnant women: A cluster randomized trial. PLoS One 2015; 10(2): e0117181.
Polsky S, Giordano D, Voelmle MK, Garcetti R, Garg SK. Using technology to advance type 1 diabetes care among women during the reproductive years and in pregnancy. Postgrad Med 2016; 128(4): 418-26.
Telephonic DM approach to maternity management produces solid returns. Clin Res Manag 2001; 2(3): 41-4,33.
Forsell E, Bendix M, Holländare F, et al. Internet delivered cognitive behavior therapy for antenatal depression: A randomised controlled trial. J Affect Disord 2017; 221: 56-64.
Kingston D, Austin MP. Pregnant women’s views on the feasibility and acceptability of web-based mental health e-screening versus paper-based screening: A randomized controlled trial. J Med Internet Res 2017; 19(4): e88.
Marcano Belisario JS, Doherty K, O’Donoghue J, Ramchandani P, Majeed A. A bespoke mobile application for the longitudinal assessment of depression and mood during pregnancy: Protocol of a feasibility study. BMJ Open 2017; 7(5): e014469.
Marcano-Belisario JS, Gupta AK, O’Donoghue J, Morrison C, Car J. Tablet computers for implementing NICE antenatal mental health guidelines: protocol of a feasibility study. BMJ Open 2016; 6(1): e009930.
Gordon M, Henderson R, Holmes JH, Wolters MK, Bennett IM. Participatory design of ehealth solutions for women from vulnerable populations with perinatal depression. J Am Med Inform Assoc 2016; 23(1): 105-9.
Feroz A, Perveen S, Aftab W. Role of mHealth applications for improving antenatal and postnatal care in low and middle income countries: A systematic review. BMC Health Serv Res 2017; 17(1): 704.
Watterson JL, Walsh J, Madeka I. Using mHealth to improve usage of antenatal care, postnatal care, and immunization: A systematic review of the literature. BioMed Res Int 2015; 2015: 153402.
Gyselaers W, Storms V, Grieten L. New technologies to reduce medicalization of prenatal care: A contradiction with realistic perspectives. Expert Rev Med Devices 2016; 13(8): 697-9.
Magann EF, Bronstein J, McKelvey SS, Wendel P, Smith DM, Lowery CL. Evolving trends in maternal fetal medicine referrals in a rural state using telemedicine. Arch Gynecol Obstet 2012; 286(6): 1383-92.
Tuon RA, Ambrosano GM, Silva SM, Pereira AC. [Telephone monitoring service for pregnant women and impact on prevalence of prematurity and associated risk factors in Piracicaba, São Paulo State, Brazil]. Cad Saude Publica 2016; 32(7) S0102-311X2016000705001
Bush J, Barlow DE, Echols J, Wilkerson J, Bellevin K. Impact of a Mobile Health Application on User Engagement and Pregnancy Outcomes Among Wyoming Medicaid Members. Telemed J E Health 2017; 23(11): 891-8.
Sondaal SF, Browne JL, Amoakoh-Coleman M, et al. Assessing the effect of mHealth interventions in improving maternal and neonatal care in low- and middle-income countries: A Systematic Review. PLoS One 2016; 11(5): e0154664.
Tamrat T, Kachnowski S. Special delivery: An analysis of mHealth in maternal and newborn health programs and their outcomes around the world. Matern Child Health J 2012; 16(5): 1092-101.
Colaci D, Chaudhri S, Vasan A. mHealth interventions in low-income countries to address maternal health: A systematic review. Ann Glob Health 2016; 82(5): 922-35.
Lee SH, Nurmatov UB, Nwaru BI, Mukherjee M, Grant L, Pagliari C. Effectiveness of mHealth interventions for maternal, newborn and child health in low- and middle-income countries: Systematic review and meta-analysis. J Glob Health 2016; 6(1): 010401.
Ngabo F, Nguimfack J, Nwaigwe F, et al. Designing and Implementing an Innovative SMS-based alert system (RapidSMS-MCH) to monitor pregnancy and reduce maternal and child deaths in Rwanda. Pan Afr Med J 2012; 13: 31.
Pflugeisen BM, Mou J. Patient Satisfaction with Virtual Obstetric Care. Matern Child Health J 2017; 21(7): 1544-51.
Harrison TN, Sacks DA, Parry C, Macias M, Ling Grant DS, Lawrence JM. Acceptability of virtual prenatal visits for women with gestational diabetes women's health issues 2017; 27(3): 351-5.
Jareethum R, Titapant V, Chantra T, Sommai V, Chuenwattana P, Jirawan C. Satisfaction of healthy pregnant women receiving short message service via mobile phone for prenatal support: A randomized controlled trial. J Med Assoc Thai 2008; 91(4): 458-63.
Otten E, Birnie E, Ranchor AV, van Langen IM. Telegenetics use in presymptomatic genetic counselling: patient evaluations on satisfaction and quality of care. Eur J Hum Genet 2016; 24(4): 513-20.
McCrossan BA, Sands AJ, Kileen T, Doherty NN, Casey FA. A fetal telecardiology service: patient preference and socio-economic factors. Prenat Diagn 2012; 32(9): 883-7.
Otten E, Birnie E, Ranchor AV, van Langen IM. Online genetic counseling from the providers’ perspective: counselors’ evaluations and a time and cost analysis. Eur J Hum Genet 2016; 24(9): 1255-61.
Xydopoulos G, Perry H, Sheehan E, Thilaganathan B, Fordham R, Khalil A. Home blood-pressure monitoring in a hypertensive pregnant population: Cost minimisation study. Ultrasound Obstet Gynecol 2019; 53(4): 496-502.
Tõrõk M, Kovács F, Doszpod J. Cost-effectiveness of home telemedical cardiotocography compared with traditional outpatient monitoring. J Telemed Telecare 2000; 6(Suppl. 1): S69-70.
Ippolito A, De Falco M, Triassi M, Di Lieto A. A cost study of prenatal telemedicine. J Telemed Telecare 2003; 9(5): 288-91.
Dowie R, Mistry H, Young TA, Franklin RC, Gardiner HM. Cost implications of introducing a telecardiology service to support fetal ultrasound screening. J Telemed Telecare 2008; 14(8): 421-6.
Boston-Fleischhauer C. The explosion of virtual nursing care. J Nurs Adm 2017; 47(2): 85-7.
Haghi M, Thurow K, Stoll R. Wearable devices in medical internet of things: Scientific research and commercially available devices. Healthc Inform Res 2017; 23(1): 4-15.
Dimitrov DV. Medical internet of things and big data in healthcare. Healthc Inform Res 2016; 22(3): 156-63.
Organization WH. Medical devices: Managing the mismatch: An outcome of the priority medical devices project 2010.
Sharp M, O’Sullivan D. Mobile Medical apps and mhealth devices: A framework to build medical apps and mhealth devices in an ethical manner to promote safer use - a literature review. Stud Health Technol Inform 2017; 235: 363-7.
Stergiou GS, Alpert BS, Mieke S, Wang J. Validation protocols for blood pressure measuring devices in the 21st century 2018; 20(7): 1096-9.
Stergiou GS, Asmar R, Myers M, et al. Improving the accuracy of blood pressure measurement: the influence of the European Society of Hypertension International Protocol (ESH-IP) for the validation of blood pressure measuring devices and future perspectives. J Hypertens 2018; 36(3): 479-87.
Rodziewicz TL, Hipskind JE. Medical Error Prevention StatPearls. Treasure Island, FL: StatPearls Publishing StatPearls Publishing LLC 2018.
Henneman EA, Gawlinski A, Blank FS, Henneman PL, Jordan D, McKenzie JB. Strategies used by critical care nurses to identify, interrupt, and correct medical errors. Am J Crit Care 2010; 19(6): 500-9.
Mattox E. Medical devices and patient safety. Crit Care Nurse 2012; 32(4): 60-8.
Stempniak M. Health Care Hackers: Hackers of medical devices pose a potential threat to patient safety. Hosp Health Netw 2015; 89(10): 15.
Andriole KP. Security of electronic medical information and patient privacy: what you need to know. J Am Coll Radiol 2014; 11(12 Pt B): 1212-6.
Kavoussi SC, Huang JJ, Tsai JC, Kempton JE. HIPAA for physicians in the information age. Conn Med 2014; 78(7): 425-7.
Council EPat. Regulation (EU) 2016/679 of the European Parliament and of the Council of 27 April 2016 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data, and repealing Directive 95/46/EC (General Data Protection Regulation) (Text with EEA relevance). Brussels 2016.
Tipton SJ, Forkey S, Choi YB. Toward Proper Authentication Methods in Electronic Medical Record Access Compliant to HIPAA and C.I.A. Triangle. J Med Syst 2016; 40(4): 100.
Yamada M, Okigaki T, Awai M. Role of superoxide radicals in cytotoxic effects of Fe-NTA on cultured normal liver epithelial cells. Cell Struct Funct 1987; 12(5): 407-20.
Tirado M. Role of mobile health in the care of culturally and linguistically diverse US populations. Perspect Health Inf Manag 2011; 8: 1e.
Pantoja T, Opiyo N, Lewin S, et al. Implementation strategies for health systems in low-income countries: An overview of systematic reviews. Cochrane Database Syst Rev 2017; 9: CD011086.
White P. Legal issues in teleradiology-distant thoughts! Br J Radiol 2002; 75(891): 201-6.
Greiner AL. Telemedicine Applications in Obstetrics and Gynecology. Clin Obstet Gynecol 2017; 60(4): 853-66.
Yang YT, Silverman RD. Mobile health applications: the patchwork of legal and liability issues suggests strategies to improve oversight. Health Aff (Millwood) 2014; 33(2): 222-7.
Campagna M, Naka F, Lu J. Teledermatology: An updated overview of clinical applications and reimbursement policies. Int J Womens Dermatol 2017; 3(3): 176-9.
Lanssens D, Vandenberk T, Smeets CJ, et al. Prenatal remote monitoring of women with gestational hypertensive diseases: cost analysis. J Med Internet Res 2018; 20(3): e102.
Kalafat E, Mir I, Perry H, Thilaganathan B, Khalil A. Is Home Blood Pressure Monitoring in Hypertensive Disorders of Pregnancy Consistent with Clinic Recordings 2018; 52(4): 515-21.
Forkan ARM, Khalil I. A clinical decision-making mechanism for context-aware and patient-specific remote monitoring systems using the correlations of multiple vital signs. Comput Methods Programs Biomed 2017; 139: 1-16.
Schatz BR. National surveys of population health: Big data analytics for mobile health monitors. Big Data 2015; 3(4): 219-29.
Leskosek B, Ferk P. Telepharmacology in clinical practice? Stud Health Technol Inform 2013; 192: 1220.
Seebregts C, Dane P, Parsons AN, et al. Designing for scale: Optimising the health information system architecture for mobile maternal health messaging in South Africa (MomConnect). BMJ Glob Health 2018; 3(Suppl. 2): e000563.
Halili L, Liu R, Hutchinson KA, Semeniuk K, Redman LM, Adamo KB. Development and pilot evaluation of a pregnancy-specific mobile health tool: A qualitative investigation of SmartMoms Canada. BMC Med Inform Decis Mak 2018; 18(1): 95.
Ginja S, Coad J, Bailey E, et al. Associations between social support, mental wellbeing, self-efficacy and technology use in first-time antenatal women: data from the BaBBLeS cohort study. BMC Pregnancy Childbirth 2018; 18(1): 441.
Olivia Kim U, Barnekow K, Ahamed SI, et al. Smartphone-based prenatal education for parents with preterm birth risk factors Patient Educ Couns 2018. 2019; 102(4): 701-8.
Materia FT, Smyth JM, Heron KE, et al. Preconceptional health behavior change in women with overweight and obesity: Prototype for SMART strong healthy women intervention. mHealth 2018; 4: 24.
Daly LM, Horey D, Middleton PF, Boyle FM, Flenady V. The effect of mobile app interventions on influencing healthy maternal behavior and improving perinatal health outcomes: Systematic review. JMIR Mhealth Uhealth 2018; 6(8): e10012.
Davies A, Rixon L, Newman S. Systematic review of the effects of telecare provided for a person with social care needs on outcomes for their informal carers. Health Soc Care Community 2013; 21(6): 582-97.
von Dadelszen P, Magee LA, Payne BA, et al. Moving beyond silos: How do we provide distributed personalized medicine to pregnant women everywhere at scale? Insights from PRE-EMPT. Int J Gynaecol Obstet 2015; 131(Suppl. 1): S10-5.
von Dadelszen P, Sawchuck D, Justus Hofmeyr G, et al. PRE-EMPT (PRE-eclampsia-Eclampsia Monitoring, Prevention and Treatment): A low and middle income country initiative to reduce the global burden of maternal, fetal and infant death and disease related to pre-eclampsia. Pregnancy Hypertens 2013; 3(4): 199-202.
Mackillop L, Hirst JE, Bartlett KJ, et al. Comparing the efficacy of a mobile phone-based blood glucose management system with standard clinic care in women with gestational diabetes: Randomized controlled trial. JMIR Mhealth Uhealth 2018; 6(3): e71.
Guo H, Zhang Y, Li P, Zhou P, Chen LM, Li SY. Evaluating the effects of mobile health intervention on weight management, glycemic control and pregnancy outcomes in patients with gestational diabetes mellitus. J Endocrinol Invest 2018.
Miremberg H, Ben-Ari T, Betzer T, et al. The impact of a daily smartphone-based feedback system among women with gestational diabetes on compliance, glycemic control, satisfaction, and pregnancy outcome: A randomized controlled trial. Am J Obstet Gynecol 2018; 218(4): 453.e1-e7.
Skar JB, Garnweidner-Holme LM, Lukasse M, Terragni L. Women’s experiences with using a smartphone app (the Pregnant+ app) to manage gestational diabetes mellitus in a randomised controlled trial. Midwifery 2018; 58: 102-8.
Vashist SK, Schneider EM, Luong JH. Commercial smartphone-based devices and smart applications for personalized healthcare monitoring and management. Diagnostics 2014; 4(3): 104-28.
Chan AH, Harrison J, Black PN, Mitchell EA, Foster JM. Using electronic monitoring devices to measure inhaler adherence: A practical guide for clinicians. J Allergy Clin Immunol Pract 2015; 3(3): 335-49.e1-5..
Ferreri F, Bourla A, Mouchabac S, Karila L. e-Addictology: An Overview of New Technologies for Assessing and Intervening in Addictive Behaviors. Front Psychiatry 2018; 9: 51.
Nichols V, Thériault-Dubé I, Touzin J, et al. Risk perception and reasons for noncompliance in pharmacovigilance: A qualitative study conducted in Canada. Drug Saf 2009; 32(7): 579-90.
Montastruc F, Bagheri H, Lacroix I, et al. Adverse drug reaction reports received through the mobile App, VigiBIP®: A comparison with classical methods of reporting. Drug Saf 2018; 41(5): 511-4.
Carreiro S, Chai PR, Carey J, Chapman B, Boyer EW. Integrating personalized technology in toxicology: Sensors, smart glass, and social media applications in toxicology research. J Med Toxicol 2017; 13(2): 166-72.
Bernard R, Bowsher G, Milner C, Boyle P, Patel P, Sullivan R. Intelligence and global health: Assessing the role of open source and social media intelligence analysis in infectious disease outbreaks. Z Gesundh wiss 2018; 26(5): 509-14.
Timko BP, Kohane DS. Materials to clinical devices: Technologies for remotely triggered drug delivery. Clin Ther 2012; 34(11): S25-35.
Davoodi P, Lee LY, Xu Q, et al. Drug delivery systems for programmed and on-demand release. Adv Drug Deliv Rev 2018; 132: 104-38.
Izmailova ES, Wagner JA, Perakslis ED. Wearable devices in clinical trials: Hype and hypothesis. Clin Pharmacol Ther 2018; 104(1): 42-52.
Alharbi I, Alyoubi B, Hoque MR, Almazmomi N. Big data based m-health application to prevent health hazards: a design science framework. Telemed J E Health 2019; 25(4): 326-31.
Gill SK, Christopher AF, Gupta V, Bansal P. Emerging role of bioinformatics tools and software in evolution of clinical research. Perspect Clin Res 2016; 7(3): 115-22.

Rights & PermissionsPrintExport Cite as

Article Details

Year: 2019
Published on: 02 June, 2019
Page: [615 - 623]
Pages: 9
DOI: 10.2174/1381612825666190320140659
Price: $65

Article Metrics

PDF: 50
PRC: 1