An Israeli hospital is asking expectant mothers in its coronavirus maternity ward to check their unborn babies’ heartbeats themselves, in a bid to avoid unnecessary contact as part of its development of remote care protocols.
Sheba Medical Center has started to provide its pregnant virus-positive patients with a new Israeli-developed handheld system they use to monitor the fetal heart rate. It has also introduced a patient-operated device, also Israeli-made, for performing ultrasounds, and claims to be the first hospital in the world enabling patients to perform both checks without a doctor or nurse present.
“Pregnant women with COVID-19 symptoms are at increased risk of severe illness,” Dr. Avi Tsur, who spearheaded the move, told The Times of Israel. “But on the other hand we’re very careful in trying to prevent cross-infections between them, staff and other patients.”
“Every check requires staff to put on protective clothing, and necessitates extensive cleaning of equipment used,” he noted.
This solution allows the kind of very close monitoring that pregnant COVID-19 patients need, given their increased risk, while eliminating challenges raised by their virus-positive status, he said.
Home fetal health monitors have been widely available for over a decade, but practitioners warn that without oversight by trained professionals they can provide false impressions of a baby’s state.
The Sheba protocol, which was in development before the pandemic and which the hospital hopes will become the “clinical paradigm” of the future, will allow remote oversight of the monitoring process.
Both checks are carried out by women placing devices on their abdomens and moving them as instructed by a doctor who remotely guides the process. Data and images from the checks are automatically sent to doctors.
“Even patients who aren’t technologically-minded, and who don’t have a smartphone, are showing they are able to use the equipment,” Tsur said.
“We’re putting technologies together, and integrating them into our IT systems, so they deliver a comprehensive integrated solution that allows for much of pregnant women’s care without physical contact with a doctor,” he added.
Sheba, which had the first coronavirus ward in the country, has consistently sought to lead the way in innovating solutions for remote monitoring. Tsur claimed that the hospital was the only one integrating such a system.
The new protocol represents one of the first pilot deployments of HeraBEAT, which provides real-time fetal and maternal heart rate monitoring, and prepares data for analysis by midwives and obstetricians. The tech is currently undergoing its second clinical trial, at the Mayo Clinic in the United States.
At Sheba, HeraBEAT is being deployed alongside the PulseNmore ultrasound device, which it is also piloting. This tech provides scans to medical staff who assess fetal health by observing cardiac activity, movement, and amniotic fluid volumes. Sheba is the second Israeli health provider to deploy PulseNmore, after Clalit Health Services, which started offering it to pregnant members in the summer.
Tsur said that the pandemic expedited Sheba’s gradual process of moving toward remote care for expectant moms. “For quite some time we have been looking for ways for pregnant women to receive some of their monitoring at home,” he commented.
“We hope now that this advance will change the clinical paradigm for the future, beyond the pandemic. Integrating these existing technology into clinical care, which can allow patients to have monitoring at home, can allow us to reduce clinical visits and have more home assessment.”