Alex Peahl, Kristy Richter, Julia Erickson, Tina Chen, Shreya Venkataperumal, Sarah Dwyer, Daria Stelmak, Sarah Bell MS MPH, Sarah Davis, Molly Stout MD MSCI
University of Michigan Department of Obstetrics and Gynecology, Ann Arbor, Michigan
Background
Prenatal care in the United States has not changed since 1933
• The current model fails to detect and prevent adverse outcomes when
considering access, service delivery, and patient experience
• Antenatal testing is key in identifying chronic conditions and treating
appropriately to improve maternal health outcomes
• Biophysical profiles (BPPs) are a form of antenatal testing that look at four
key parameters of fetal well-being: gross body movement, tone, breathing,
and amniotic fluid
• Social needs can make obtaining prenatal care burdensome for patients
• Home-use antenatal testing devices play a key role in improving prenatal
care and pregnancy outcomes.ive.
Objective
To assess the feasibility of patient-operated remote
ultrasonography for completing biophysical profiles
(BPPs) for antenatal surveillance in high-risk pregnancies.
Methods
Observational, non-intervention trial assessing feasibility and
acceptability of patient-operated remote ultrasound for completing BPPs
for antenatal surveillance in high-risk pregnancies
• Inclusion criteria: Pregnant at >24 weeks GA, BMI <40, with no fetal
anomalies, presenting for planned antenatal surveillance for maternal
or fetal conditions including BPP at Michigan Medicine
• Primary outcome: Detectability of BPP components
• Secondary outcome: Agreement of BPP components between research
and clinical scans
• Exploratory outcome: Detectability and agreement of additional
components (presentation, placental location, fetal heartbeat)
Results
25 completed research scans
• Mean age, 32 years; mean BMI, 29
• Current pregnancy complications included gestational diabetes (28%),
hypertension (24%), and intrauterine growth restriction (20%)
Feasibility and Acceptability
The Pulsenmore ES device demonstrated 100% detectability of BPP
components
• Agreement between research and clinical scans was high for most
components, but additional work is needed for placental location
• Patient-reported outcomes were high (on 1-7 scale) across all domains
(usefulness, ease of use, ease of learning, satisfaction)
Conclusion
Patient-operated remote ultrasonography with clinician guidance
appears feasible and acceptable for antenatal surveillance in high-risk
pregnancies—particularly for patients with unmet social needs and those
facing barriers to care.
