Miklós Török

Regional and international prenatal telemedicine network for computerized antepartum cardiotocography.

The objective of this work was to review the activity of TOCOMAT, a system for antepartum cardiotocographic telemonitoring. Nine peripheral units recorded the traces, transmitted them via modem to the University operation center, where the computerized analysis was performed, and received the medical report within a few minutes, via fax or e-mail. Traces were classified as reassuring, nonreassuring, or pathological. The parameters of computerized analysis were grouped together for each week of gestation. The perinatal outcome was also evaluated. In 5 years, 5830 traces were analyzed: 4372 (75%) from 1344 high-risk patients and 1458 (25%) from 529 patients at apparent low risk. The system allowed the identification of high-risk patients (32.8% with nonreassuring traces and 7.1% with pathologic traces) and lowrisk patients (16.3% with nonreassuring traces and 4.3% with pathologic traces) that required further evaluation. The neonatal outcome was good overall. At each week of pregnancy, the mean values of computerized parameters resulted in normal ranges. The TOCOMAT system allowed a decentralization of prenatal surveillance and improved the patients quality of life and the level of prenatal care.

A new, phonocardiography-based telemetric fetal home monitoring system.

The purpose of this article is to describe a new, phonocardiography-based fetal telemonitoring system, which, due to its passive nature, allows long-term measurements even at the home of the pregnant woman. The input element of the system was the home monitor with two sensors for recording the trans-abdominal fetal heart signal and the uterine contractions. The recorded signal was transmitted by mobile network and Internet to an Evaluation Center, where it was analyzed in detail to obtain information about possible dysfunction of the fetal heart. The investigations on this system made clear that by advanced processing of the recorded signal the system captured many additional cardiac features compared with the traditional ultrasound-based cardiotocographic procedure.