Abstract
BACKGROUND: We investigated the use of virtual telehealth visits (VV) for prenatal checkups in Japan during the coronavirus disease (COVID-19) pandemic, identified challenges associated with their use, and assessed the feasibility of future VV implementation for prenatal care. METHODS: Surveys were conducted at birthing facilities across Japan and with pregnant women attending Osaka and Keio University hospitals. To assess the feasibility of VV, we compared the self-measured blood pressure, fundal height, urinary test results, and fetal heart rate of pregnant women with those measured by healthcare providers. RESULTS: We received responses from 1,096 birthing facilities (49.5% response rate) and 96 women. Only 1.6% of birthing facilities implemented VV, mainly due toto a lack of human resources, costs, and low demand from both patients and healthcare providers. In contrast, 60.2% of pregnant women expressed anxiety about in-person visits during the pandemic, and 36.6% preferred the introduction of VV. The Pearson correlation coefficients between self-measured and provider-measured values systolic and diastolic blood pressure and fundal height were 0.68, 0.58, and 0.87, respectively. The concordance rates for proteinuria and urinary glucose were 91.6% and 98.9%, respectively. However, the correlation for fetal heart rate measurements was poor (-0.04). Bland-Altman analysis revealed 95% limits of agreement ranging from -42.6 to 65.6 bpm, indicating the need for methodological improvement. CONCLUSION: Despite maternal interest, VV has been limitedly implemented in Japan. Our study found that self-measured values, except for fetal heart rate, were highly correlated with those measured by healthcare providers. These findings are important for healthcare providers and government agencies when considering future prenatal checkups.