title: Prenatal diagnosis and telemedicine consultation of fetal urologic disorders.
abstract: In Arkansas, telemedicine is used commonly in obstetrics through Antenatal and Neonatal Guidelines, Education and Learning System (ANGELS), the existing statewide telemedicine network. This network is used primarily for tele-ultrasound and maternal-fetal medicine consultation. This study is a retrospective case series, describing all the patients who had a prenatally diagnosed urologic anomaly that required prenatal urologic consultation. From 2009-2013, approximately 1300 anomalies were recorded in the Arkansas Fetal Diagnosis and Management (AFDM) database, 14% of which were urologic anomalies. Twenty-six cases required prenatal urologic consultation, 25 of which were conducted via telemedicine. Teleconsultation allowed patients to combine maternal-fetal medicine and urologic consultations in one visit, saving time and effort and ultimately, for most patients, providing reassurance that delivery could be accomplished locally with postnatal follow-up already arranged. While there are several studies reporting the use of telemedicine for various subspecialty consultations, to our knowledge, this is the first to describe the use of telemedicine for prenatal urology consultation. Future research could randomize patients prospectively to allow comparison of both the outcomes as well as the patient experience.
authors.affiliation: Department of Obstetrics and Gynecology, University of Arkansas for the Medical Sciences, USA nrabie@uams.edu.
authors.forename: Nader Z
authors.initials: NZ
authors.lastname: Rabie
authors.affiliation: Department of Pediatric Urology, University of Arkansas for the Medical Sciences, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Canon
authors.affiliation: Department of Pediatric Urology, University of Arkansas for the Medical Sciences, USA.
authors.forename: Ashay
authors.initials: A
authors.lastname: Patel
authors.affiliation: Department of Pediatric Urology, University of Arkansas for the Medical Sciences, USA.
authors.forename: Ismael
authors.initials: I
authors.lastname: Zamilpa
authors.affiliation: Department of Obstetrics and Gynecology, University of Arkansas for the Medical Sciences, USA.
authors.forename: Everett F
authors.initials: EF
authors.lastname: Magann
authors.affiliation: University of Oklahoma College of Medicine, USA.
authors.forename: Jared
authors.initials: J
authors.lastname: Higley
mesh_terms: D001131:Arkansas; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis*; D006801:Humans; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*; D012017:Referral and Consultation; D019114:Remote Consultation / Q000379:methods*; D012189:Retrospective Studies; D014564:Urogenital Abnormalities / Q000175:diagnosis / Q000196:embryology; D014570:Urologic Diseases / Q000175:diagnosis / Q000196:embryology*
keywords: Telemedicine; pediatric urology; perinatal care; pregnancy; prenatal ultrasonography; urologic anomalies