VALIDATION OF FIRST-TRIMESTER TELEMEDICINE AS AN OBSTETRIC IMAGING TECHNOLOGY - A FEASIBILITY STUDY

Objective: To establish whether first-trimester obstetric ultrasonogra phy interpreted by a live video telemedicine link is comparable to an established videotape review network in a low-risk patient population. Methods: An integrated services digital network was established from three satellite offices to our central prenatal diagnostic center. All patients had a sonographic evaluation of the uterus, adnexa, and gest ational sac recorded onto videotape by a trained sonographer. A live, interactive video telemedicine link was established, and a perinatolog ist directed the sonographer through the scan. Subsequently, a differe nt perinatologist, blinded to the telemedicine interpretation, reviewe d the original videotaped examination. The reports generated from both modalities then were compared by means of a score of 12 sonographic c haracteristics. Results: The first 100 patients were included. The mea n gestational age (+/- standard deviation) was 8.9 +/- 2.3 weeks (rang e 5.7-14.4), and the mean duration for telemedicine scans was 7.8 +/- 2.9 minutes (range 3.8-20.1). Telemedicine and videotape review scores were the same in 95 cases, and the final diagnosis was identical in 9 8 cases. This study had 80% power to detect a 10% difference in diagno sis at a significance level of .05. The ability to detect abnormalitie s was equivalent using both systems. Conclusion: The interpretation of first-trimester obstetric ultrasonography using live video telemedici ne is equivalent to a system of videotape review. Obstetric telemedici ne may prove to be a useful tool for providing sonographic imaging for low-risk obstetric patients. (C) 1997 by The American College of Obst etricians and Gynecologists.