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Clinical Obstetrics

Poster Session 1

(231) Impact of OBTeleflex Program on Delivery Outcomes at an Academic Urban Center

Tuesday, February 13, 2024
10:30 AM – 12:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: Studies have shown that telehealth can improve obstetric outcomes such as smoking cessation and breastfeeding rates. However, the effect of telehealth on outcomes such as mode of delivery has not been adequately investigated.

Study Design: We performed a retrospective cohort study of all patients who initiated prenatal care between October 1st 2021 and September 30th 2022 at a major urban academic center. Patients were included if they were eligible for OBTeleflex, a hybrid telemedicine/in-person prenatal program that provides flexible, education-oriented prenatal care where 6 traditional antepartum/postpartum visits are replaced by remote visits with an OB nurse navigator. Low risk patients were eligible for OBTeleflex and included in this study if they had a singleton, viable, non-anomalous fetus, and did not have hypertension requiring medication. The primary outcome was mode of delivery. Patients who elected to participate in OBTeleflex were compared to those who opted for routine care. Standard labor management were per hospital protocol and maternal characteristics and pregnancy outcomes were collected from the EMR.

Results: Of the 351 patients eligible for the OB Teleflex program, 63 (18%) chose to participate. The groups differed by race but other maternal characteristics did not differ significantly (Table). OBTeleflex participation was associated with a significantly higher rate of vaginal delivery compared to routine prenatal care (81% vs. 68%, p = 0.04) and lower rates of perineal tears (p=0.02). Rates of vaginal delivery did not differ significantly between OBTeleflex and routine prenatal care when comparing only nulliparous patients (78% vs. 66%, p = 0.14).

Conclusion: In this small cohort, a hybrid prenatal telemedicine program was associated with similar delivery outcomes in nullips and an increased rate of vaginal delivery in all comers compared to routine prenatal care. A randomized trial may help to elucidate whether the increased flexibility and education in programs like OBTeleflex can lead to improved delivery outcomes.