Abstract：
BACKGROUND: Patients with previous recurrent pregnancy loss are subject to increased maternal anxiety and reduced antenatal attachment during the subsequent pregnancy. Maternal anxiety is associated with worse pregnancy and neonatal outcomes. Home ultrasound is a feasible tool with the potential to alleviate maternal anxiety by ensuring fetal well-being.
OBJECTIVE: This study aimed to investigate the impact of complementing standard prenatal care with twice-weekly telemedicine visits incorporating home ultrasound on maternal anxiety and antenatal attachment in individuals with a history of recurrent pregnancy loss.
METHODS: In this randomized controlled trial, patients with a history of 2 or more prior abortions were randomized early in their subsequent pregnancy in a 1:1 ratio into either the control group, which received standard high-risk prenatal care, or the study group, which received additional twice-weekly home-ultrasound sessions. The home-ultrasound scans assessed fetal pulse, movements, and amniotic fluid volume, aiming to provide maternal reassurance. Patients performed the scans themselves using the Pulsenmore device, with real-time guidance from a physician. Maternal anxiety was assessed using the validated State-Trait Anxiety Inventory Scale (STAI-S) and the Revised Prenatal Distress Questionnaire (NuPDQ), while maternal attachment was measured with the validated Maternal Antenatal Attachment Scale (MAAS-2) at 3 time points during pregnancy. The primary outcome was the STAI-S score at the final prenatal visit. A sample size of 50 patients was calculated to detect a 20% difference in the primary outcome.
RESULTS: Of the 57 patients recruited, 50 completed the follow-up, 25 in each group. There were no significant differences in demographics between the groups. The primary outcome (STAI score at the last visit) was significantly lower in the device group compared to the control group (P=.037). In addition, the study group exhibited a greater reduction in STAI scores between the first and last visits (P=.045), and a significantly higher MAAS score at the end of the follow-up period (P=.046).
CONCLUSIONS: Integrating routine home-ultrasound telemedicine visits into prenatal care can significantly reduce maternal anxiety during pregnancy and contribute to greater maternal attachment in individuals with a history of recurrent pregnancy loss. These results emphasize the potential benefits of home ultrasound as a tool to alleviate anxiety, provide a sense of control, and foster a deeper maternal connection among pregnant individuals who have experienced previous pregnancy loss.
OBJECTIVE: This study aimed to investigate the impact of complementing standard prenatal care with twice-weekly telemedicine visits incorporating home ultrasound on maternal anxiety and antenatal attachment in individuals with a history of recurrent pregnancy loss.
METHODS: In this randomized controlled trial, patients with a history of 2 or more prior abortions were randomized early in their subsequent pregnancy in a 1:1 ratio into either the control group, which received standard high-risk prenatal care, or the study group, which received additional twice-weekly home-ultrasound sessions. The home-ultrasound scans assessed fetal pulse, movements, and amniotic fluid volume, aiming to provide maternal reassurance. Patients performed the scans themselves using the Pulsenmore device, with real-time guidance from a physician. Maternal anxiety was assessed using the validated State-Trait Anxiety Inventory Scale (STAI-S) and the Revised Prenatal Distress Questionnaire (NuPDQ), while maternal attachment was measured with the validated Maternal Antenatal Attachment Scale (MAAS-2) at 3 time points during pregnancy. The primary outcome was the STAI-S score at the final prenatal visit. A sample size of 50 patients was calculated to detect a 20% difference in the primary outcome.
RESULTS: Of the 57 patients recruited, 50 completed the follow-up, 25 in each group. There were no significant differences in demographics between the groups. The primary outcome (STAI score at the last visit) was significantly lower in the device group compared to the control group (P=.037). In addition, the study group exhibited a greater reduction in STAI scores between the first and last visits (P=.045), and a significantly higher MAAS score at the end of the follow-up period (P=.046).
CONCLUSIONS: Integrating routine home-ultrasound telemedicine visits into prenatal care can significantly reduce maternal anxiety during pregnancy and contribute to greater maternal attachment in individuals with a history of recurrent pregnancy loss. These results emphasize the potential benefits of home ultrasound as a tool to alleviate anxiety, provide a sense of control, and foster a deeper maternal connection among pregnant individuals who have experienced previous pregnancy loss.
摘要：
背景：先前反复妊娠流产的患者在随后的妊娠期间，母体焦虑增加，产前依恋减少。母亲的焦虑与更糟糕的妊娠和新生儿结局有关。家庭超声是一种可行的工具，有可能通过确保胎儿健康来缓解母亲的焦虑。
目的：本研究旨在探讨每周两次的家庭超声远程医疗访视补充标准产前护理对有反复妊娠流产史的个体产妇焦虑和产前依恋的影响。
方法：在这项随机对照试验中，有两次或两次以上流产史的患者在随后的妊娠早期以1:1的比例随机分为对照组,接受了标准的高风险产前护理，或者研究小组，每周两次接受额外的家庭超声检查。家庭超声扫描评估胎儿脉搏，运动,和羊水体积,旨在让产妇放心。患者使用Pulsenmore设备自己进行扫描，在医生的实时指导下。使用经过验证的状态特质焦虑量表（STAI-S）和修订的产前困扰问卷（NuPDQ）评估产妇的焦虑，而在怀孕期间的三个时间点使用经过验证的母体产前依恋量表（MAAS-2）测量母体依恋。主要结果是最后一次产前检查时的STAI-S评分。计算50例患者的样本量，以检测主要结果的20％差异。
结果：在招募的57名患者中，50人完成了后续工作，每组25人。两组之间的人口统计学没有显着差异。与对照组相比，器械组的主要结局（最后一次就诊时的STAI评分）显着降低（p=0.037）。此外,研究组在第一次和最后一次就诊之间表现出更大的STAI评分下降（p=0.045），随访期结束时MAAS评分明显较高(p=0.046)。
结论：将常规家庭超声远程医疗访视纳入产前护理可以显著降低孕妇在怀孕期间的焦虑，并有助于有复发性妊娠流产史的个体提高母亲的依恋。这些结果强调了家庭超声作为缓解焦虑的工具的潜在好处，提供控制感，并在经历过怀孕失败的孕妇中建立更深层次的母亲联系。
目的：本研究旨在探讨每周两次的家庭超声远程医疗访视补充标准产前护理对有反复妊娠流产史的个体产妇焦虑和产前依恋的影响。
方法：在这项随机对照试验中，有两次或两次以上流产史的患者在随后的妊娠早期以1:1的比例随机分为对照组,接受了标准的高风险产前护理，或者研究小组，每周两次接受额外的家庭超声检查。家庭超声扫描评估胎儿脉搏，运动,和羊水体积,旨在让产妇放心。患者使用Pulsenmore设备自己进行扫描，在医生的实时指导下。使用经过验证的状态特质焦虑量表（STAI-S）和修订的产前困扰问卷（NuPDQ）评估产妇的焦虑，而在怀孕期间的三个时间点使用经过验证的母体产前依恋量表（MAAS-2）测量母体依恋。主要结果是最后一次产前检查时的STAI-S评分。计算50例患者的样本量，以检测主要结果的20％差异。
结果：在招募的57名患者中，50人完成了后续工作，每组25人。两组之间的人口统计学没有显着差异。与对照组相比，器械组的主要结局（最后一次就诊时的STAI评分）显着降低（p=0.037）。此外,研究组在第一次和最后一次就诊之间表现出更大的STAI评分下降（p=0.045），随访期结束时MAAS评分明显较高(p=0.046)。
结论：将常规家庭超声远程医疗访视纳入产前护理可以显著降低孕妇在怀孕期间的焦虑，并有助于有复发性妊娠流产史的个体提高母亲的依恋。这些结果强调了家庭超声作为缓解焦虑的工具的潜在好处，提供控制感，并在经历过怀孕失败的孕妇中建立更深层次的母亲联系。
