Telehealth for High-Risk Pregnancies in the Setting of the COVID-19 Pandemic
- PMID: 32396948
- PMCID: PMC7356069
- DOI: 10.1055/s-0040-1712121
Telehealth for High-Risk Pregnancies in the Setting of the COVID-19 Pandemic
Abstract
As New York City became an international epicenter of the novel coronavirus disease 2019 (COVID-19) pandemic, telehealth was rapidly integrated into prenatal care at Columbia University Irving Medical Center, an academic hospital system in Manhattan. Goals of implementation were to consolidate in-person prenatal screening, surveillance, and examinations into fewer in-person visits while maintaining patient access to ongoing antenatal care and subspecialty consultations via telehealth virtual visits. The rationale for this change was to minimize patient travel and thus risk for COVID-19 exposure. Because a large portion of obstetric patients had underlying medical or fetal conditions placing them at increased risk for adverse outcomes, prenatal care telehealth regimens were tailored for increased surveillance and/or counseling. Based on the incorporation of telehealth into prenatal care for high-risk patients, specific recommendations are made for the following conditions, clinical scenarios, and services: (1) hypertensive disorders of pregnancy including preeclampsia, gestational hypertension, and chronic hypertension; (2) pregestational and gestational diabetes mellitus; (3) maternal cardiovascular disease; (4) maternal neurologic conditions; (5) history of preterm birth and poor obstetrical history including prior stillbirth; (6) fetal conditions such as intrauterine growth restriction, congenital anomalies, and multiple gestations including monochorionic placentation; (7) genetic counseling; (8) mental health services; (9) obstetric anesthesia consultations; and (10) postpartum care. While telehealth virtual visits do not fully replace in-person encounters during prenatal care, they do offer a means of reducing potential patient and provider exposure to COVID-19 while providing consolidated in-person testing and services. KEY POINTS: · Telehealth for prenatal care is feasible.. · Telehealth may reduce coronavirus exposure during prenatal care.. · Telehealth should be tailored for high risk prenatal patients..
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Conflict of interest statement
M.E.D. has had a leadership role in the American College of Obstetricians and Gynecologists II's Safe Motherhood Initiative which has received unrestricted funding from Merck for Mothers. The other authors did not report any potential conflicts of interest.
References
-
- New York State on PAUSE. 10 point planAvailable at:https://coronavirus.health.ny.gov/new-york-state-pause. Accessed April 19, 2020
-
- Lurie N, Carr B G. The role of telehealth in the medical response to disasters. JAMA Intern Med. 2018;178(06):745–746. - PubMed
-
- Hollander J E, Carr B G.Virtually perfect? Telemedicine for COVID-19N Engl J Med2020 - PubMed
MeSH terms
LinkOut - more resources
Full Text Sources
Medical
Research Materials