Aim To evaluate the feasibility of trans-abdominal fetal ECG (aECG) monitoring with portable device (MONICA AN24) during outpatient labour induction.
Methods Low risk post-term women induced with slow release PG E2 pessaries (10 mg) were allowed home for up to 24 h, while aECG, uterine activity and maternal heart rate were continuously monitored. aECG signal was transmitted from the portable device to a hospital PC via ordinary mobile phone (Bluetooth) using Trium CTG Online. aECG traces were displayed in real time on a hospital PC and intermittently reviewed by hospital staff. Women were asked to complete diaries and a subgroup was invited for face to face in depth interview.
Results 70 recruited women went home during induction. 17 women stayed at home <5 h, 19 between 5–10 h and 34>10 h. 52 (74%) returned with ruptured membranes/spontaneous labour, 8 (11.4%) recalled for signal loss, 3 (4.2%) with non-reassuring trace and 7 (10%) electively at 24 h. 55 women (79%) had vaginal delivery.
51 diaries were returned. Participants' location preferences demonstrated that, during induction of labour, women would rather be at home (n=47) than in hospital (n=4). Mean diary ratings indicated that women coped very well at home (n=48); they were very comfortable wearing the device (n=46) and were very satisfied with the outpatient monitoring (n=46).
Conclusions Continuous trans-abdominal ECG monitoring of ambulatory women undergoing induction of labour induction at home is feasible and acceptable to women. The quality of remote signal was of sufficient quality to allow clinical decision making in real time.
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