VALIDATION OF FETAL TELEMEDICINE AS A NEW OBSTETRIC IMAGING TECHNIQUE

OBJECTIVE: Our purpose was to establish whether obstetric ultrasonogra phy interpreted by a live video telemedicine link is comparable to int erpretation by videotape review in a low-risk patient population. STUD Y DESIGN: An Integrated Services Digital Network (ISDN 6) was establis hed from three satellite offices to our central prenatal diagnostic ce nter. Patients seen at these satellite offices had a complete fetal an atomic survey recorded onto videotape by a trained ultrasonographer. A live interactive video telemedicine link was then established to our center by the digital network. and a perinatologist directed the ultra sonographer through the anatomy survey, Subsequently a different perin atologist, blinded to the telemedicine interpretation, reviewed the vi deotaped examination. The reports from the videotaped and telemedicine scans were then compared on the basis of a score of 33 anatomic items . RESULTS: The first 200 patients seen at the satellite offices were i ncluded. Telemedicine and videotape interpretations provided similar s cores in 84% of scans. In 17 of the 33 anatomic categories telemedicin e provided significantly better scores than videotape, whereas in the remaining 16 anatomic categories the scores were equivalent. More vide otape than telemedicine examinations required repeat ultrasonography b ecause of suboptimal imaging (10% vs 3%, p = 0.003). CONCLUSIONS: The interpretation of obstetric ultrasonography with use of live video tel emedicine is comparable to videotape review. Fetal telemedicine may pr ove to be a useful tool for providing ultrasonographic interpretation of fetal anatomy to a network of low-risk obstetric practices.