Liat Mor, MD1, Hagit Eisenberg, MD1, Liliya Tamayev, MD1, Daniel Tairy, MD1, Ben Oren, MD1, Yael Ganor Paz, MD1, Michal Levy, MD1, Eran Weiner, MD1, Giulia Barda, MD1
1Department of Obstetrics & Gynecology, the Edith Wolfson Medical Center, Holon, Israel, affiliated with the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Objective- We aimed to evaluate the effect of incorporating twice-weekly telemedicine home-ultrasound sessions on maternal anxiety and antenatal attachment in patients with a history of late pregnancy loss.
Study Design- In this randomized controlled trial, patients with a history a pregnancy loss beyond 20 weeks of gestation were recruited during their subsequent pregnancy and randomized into either a control group receiving standard high-risk care or a study group receiving additional twice-weekly home-ultrasound sessions. Home-ultrasound scans were guided by a physician via telemedicine and assessed basic fetal wellbeing using a Pulsenmore device. Two validated questionaries assessed maternal anxiety- the State-Trait Anxiety Inventory Scale (STAI-S) and the Revised Prenatal Distress Questionnaire (NuPDQ). Maternal attachment was evaluated using the Maternal Antenatal Attachment Scale (MAAS-2). All questionnaires were filled in the beginning, mid and end of follow up time. The primary outcome was the STAI-S score at the final prenatal visit (STAI-3). In order to detect a 20% difference in the primary outcome, a sample size of 50 patients was required.
Results- Fifty patients were recruited and completed the study, 25 in each group. Demographic characteristics were similar between the groups. The home ultrasound group presented significantly decreased STAI-3 scores (p = 0.022), a significantly increased MAAS-3 score (p = 0.022) and less unscheduled emergency department visits during this time (p=0.024) compared to control. Multivariate regression analyses confirmed significant and independent associations between reduced STAI and improved MAAS and the use of home-ultrasound (Table 1).
Conclusion- Incorporating home-ultrasound visits into prenatal care in patients with prior late pregnancy loss may significantly reduce maternal anxiety and enhance maternal attachment. These findings suggest that home ultrasound technology can be a valuable tool in managing maternal anxiety in this subset of patients.
