Fd. Malone et al., VALIDATION OF FETAL TELEMEDICINE AS A NEW OBSTETRIC IMAGING TECHNIQUE, American journal of obstetrics and gynecology, 177(3), 1997, pp. 626-631
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.