J. Nores et al., VALIDATION OF FIRST-TRIMESTER TELEMEDICINE AS AN OBSTETRIC IMAGING TECHNOLOGY - A FEASIBILITY STUDY, Obstetrics and gynecology, 90(3), 1997, pp. 353-356
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.