title: Regional and international prenatal telemedicine network for computerized antepartum cardiotocography.
abstract: The objective of this work was to review the activity of TOCOMAT, a system for antepartum cardiotocographic telemonitoring. Nine peripheral units recorded the traces, transmitted them via modem to the University operation center, where the computerized analysis was performed, and received the medical report within a few minutes, via fax or e-mail. Traces were classified as reassuring, nonreassuring, or pathological. The parameters of computerized analysis were grouped together for each week of gestation. The perinatal outcome was also evaluated. In 5 years, 5830 traces were analyzed: 4372 (75%) from 1344 high-risk patients and 1458 (25%) from 529 patients at apparent low risk. The system allowed the identification of high-risk patients (32.8% with nonreassuring traces and 7.1% with pathologic traces) and lowrisk patients (16.3% with nonreassuring traces and 4.3% with pathologic traces) that required further evaluation. The neonatal outcome was good overall. At each week of pregnancy, the mean values of computerized parameters resulted in normal ranges. The TOCOMAT system allowed a decentralization of prenatal surveillance and improved the patients quality of life and the level of prenatal care.
authors.affiliation: University Federico II, Naples, Italy. dilieto@unina.it
authors.forename: Andrea
authors.initials: A
authors.lastname: Di Lieto
authors.forename: Marianna
authors.initials: M
authors.lastname: De Falco
authors.forename: Marta
authors.initials: M
authors.lastname: Campanile
authors.forename: Miklós
authors.initials: M
authors.lastname: Török
authors.forename: Spánik
authors.initials: S
authors.lastname: Gábor
authors.forename: Mariangela
authors.initials: M
authors.lastname: Scaramellino
authors.forename: Paola
authors.initials: P
authors.lastname: Schiraldi
authors.forename: Francesca
authors.initials: F
authors.lastname: Ciociola
mesh_terms: D000293:Adolescent; D000328:Adult; D015148:Cardiotocography; D005260:Female; D006801:Humans; D018670:Monitoring, Ambulatory / Q000295:instrumentation*; D011247:Pregnancy; D011295:Prenatal Care; D015397:Program Evaluation; D017216:Telemedicine / Q000458:organization & administration*