Screening fetal echocardiography by telemedicine: efficacy and community acceptance

J Am Soc Echocardiogr. 2003 Mar;16(3):202-8. doi: 10.1067/mje.2003.46.


Objective: Our aim was to assess whether tertiary level screening fetal echocardiography can be extended to primary care facilities with telemedicine assistance.

Methods: Assessment of image quality and the adequacy of fetal echocardiograms recorded after random transmission at 128, 384, or 768 kbits/s was performed. Live fetal echocardiograms were transmitted at 384 kbits/s (3 integrated services digital network lines) from the remote primary care center. Patient satisfaction was assessed by surveys obtained after office-based and telemedicine consultations.

Results: A total of 58 recorded normal studies had similar image quality and adequacy on transmission at 384 and 768 kbits/s (P =.08 and.49, respectively) and were significantly better than 128 kbits/s (P <.01). During live screening transmitted at 384 kbits/s from the primary care center, 3 of 34 fetuses were diagnosed with heart disease. Surveys from patients with direct physician contact and by telemedicine showed a high satisfaction with telemedicine-assisted screening and counseling.

Conclusion: Adequate screening for fetal heart disease is technically feasible at or above data transmission rates of 384 kbits/s. Community acceptance for telemedicine-assisted screening and counseling is not adversely affected by a lack of direct personal contact with the specialist.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Behavior
  • Community Networks
  • Data Collection
  • Echocardiography*
  • Feasibility Studies
  • Female
  • Fetal Diseases / diagnosis*
  • Fetal Diseases / epidemiology
  • Fetal Heart / diagnostic imaging*
  • Follow-Up Studies
  • Gestational Age
  • Heart Defects, Congenital / diagnosis
  • Heart Defects, Congenital / epidemiology
  • Humans
  • Image Enhancement
  • Maternal Welfare
  • Observer Variation
  • Patient Compliance
  • Patient Satisfaction
  • Pregnancy
  • Primary Health Care
  • Quality of Health Care
  • Random Allocation
  • Telemedicine*
  • Ultrasonography, Prenatal