Modified Doppler Healthy Pregnancy Monitoring (MODEM-KES) to speed up examinations of pregnant women
Downloads
Monitoring fetal health is a major factor in ensuring a healthy pregnancy and safe delivery. However, in Indonesia, especially in remote areas, limited access to quality health services, lack of sophisticated medical equipment, and difficulty reaching health facilities are serious challenges that contribute to high maternal and infant mortality rates. This study developed MODEM-KES (Modified Doppler Healthy Pregnancy Monitoring) which aims to evaluate the effectiveness of MODEM-KES in supporting health workers, especially midwives in remote areas, in conducting pregnancy monitoring more practically, accurately, and quickly. This tool integrates three important indicators: gestational age estimation, fetal weight estimation, and fetal heart rate, using Doppler sensors and fundus uteri height (FUH) measurements combined with digital methods. The research method involved testing the MODEM-KES prototype against standard tools, such as metline for FUH measurement and Doppler for FHR, with five measurements on each respondent with a gestational age of 26-40 weeks. Results showed that the difference in results between MODEM-KES and standardized tools was relatively small: FUH had a difference of 0-3 cm with an error rate of 0%-10.75%, FHR had a difference of -4/min to 4/min with an error rate of -3.0%-3.1%, and estimated fetal weight had a difference of 0-465 grams with an error rate of 0%-18.8%. Although the accuracy rate varies, MODEM-KES still shows potential as an alternative pregnancy monitoring tool that is practical and easy to use.
[1] B. S. Bisht, “Maternal Well-being in the Face of Hypoxia during Pregnancy: A Review,” Int. J. Curr. Res. Chem. Pharm. Sci, vol. 6, no. 4, pp. 27–32, 2019, doi: 10.22192/ijcrcps.
[2] S. C. Langley-Evans, J. Pearce, and S. Ellis, “Overweight, obesity and excessive weight gain in pregnancy as risk factors for adverse pregnancy outcomes: A narrative review,” J. Hum. Nutr. Diet., vol. 35, no. 2, pp. 250–264, 2022, doi: 10.1111/jhn.12999.
[3] G. T. Kiross, C. Chojenta, D. Barker, and D. Loxton, “Optimum maternal healthcare service utilization and infant mortality in Ethiopia,” BMC Pregnancy Childbirth, vol. 21, no. 1, pp. 1–12, 2021, doi: 10.1186/s12884-021-03860-z.
[4] N. K. P. Utomo, M. Gafur, N. N. Ma’rifah, D. R. Putri, C. T. Hidayat, and S. W. Asih, “The Influence of Health Education on Knowledge of Antenatal Care in Pregnant Women in Rural Areas,” J. Rural Community Nurs. Pract., vol. 2, no. 1, pp. 70–81, 2024, doi: 10.58545/jrcnp.v2i1.86.
[5] S. Lailiyah, D. Prayoga, J. D. E. Sari, S. Nuraini, and P. K. Prasetyanto, “Integrated Early Warning System for High-risk Pregnant Woman: Development of Management Information System Between PHC and Hospital,” Malaysian J. Med. Heal. Sci., vol. 20, pp. 64–69, 2024, doi: 10.47836/mjmhs.20.s9.11.
[6] Febronia Martina Dua Lehang, Aditiawarman, Ivon Diah Wittiarika, and Linda Dewanti, “Midwives’ Perceptions of Preeclampsia Screening,” Indones. Midwifery Heal. Sci. J., vol. 8, no. 2, pp. 102–116, 2024, doi: 10.20473/imhsj.v8i2.2024.102-116.
[7] J. V. Santos, G. D’Inverno, and A. Camanho, “198:poster Using the benefit-of-doubt approach for health system effectiveness: a global case study on amenable mortality,” vol. 0, p. A19.1-A19, 2022, doi: 10.1136/bmjgh-2022-isph.52.
[8] T. Susilowati, “Optimization of Health Cadres in Postpartum Maternal Management,” Int. J. Community Serv., vol. 03, no. 01, pp. 10–16, 2024, doi: 10.55299/ijcs.v3i1.715.
[9] K. Kasmasari, B. Bakhriansyah, N. Al Audhah, E. Suhartono, and M. Syahadatina, “Analysis of Factors Associated with the Incidence of Hypertension in Pregnancy: Study at RSUD dr. H. Andi Abdurrahman Noor, Tanah Bumbu Regency,” J. La Medihealtico, vol. 5, no. 2, pp. 356–363, 2024, doi: 10.37899/journallamedihealtico.v5i2.1225.
[10] S. Sriningsih, T. Haryanto, A. Solihin, and S. Sriningsih1, “Determinants of Spending Efficiency for Education and Health Functions,” Jejak, vol. 17, no. 1, p. 17, 2024.
[11] D. Wahyuni and E. Puspitasari, “the Relationship Between Preeclampsia and Low Birth Weight (Lbw) in Wonosari, Gunungkidul Regional Hospital,” Epidemiol. Soc. Heal. Rev., vol. 3, no. 1, p. 1, 2021, doi: 10.26555/eshr.v3i1.2987.
[12] S. Utami and R. Susilaningrum, “Low-birth-weight scorecard for early prevention: the accuracy for predicting low-birth-weight infants based on maternal risk factor,” J. Ners, vol. 19, no. 1, pp. 13–20, 2024, doi: 10.20473/jn.v19i1.49729.
[13] N. Raina, R. Khanna, S. Gupta, C. A. Jayathilaka, R. Mehta, and S. Behera, “Progress in achieving SDG targets for mortality reduction among mothers, newborns, and children in the WHO South-East Asia Region,” Lancet Reg. Heal. - Southeast Asia, vol. 18, p. 100307, 2023, doi: 10.1016/j.lansea.2023.100307.
[14] Dikes Prov.NTB, Laporan Kinerja Dinas Kesehatan Provinsi Nusa Tenggara Barat Tahun 2021, vol. 44, no. 2. Mataram, 2021. doi: 10.47655/dialog.v44i2.507.
[15] A. L. David and R. N. Spencer, “Clinical Assessment of Fetal Well-Being and Fetal Safety Indicators,” J. Clin. Pharmacol., vol. 62, no. S1, pp. S67–S78, 2022, doi: 10.1002/jcph.2126.
[16] Ika Yudianti, Dessy Amelia, Nur Eva Aristina, and Nina Primasari, “Pregnant Women Empowerment in Monitoring Fetal Wellbeing Through Fetal Movement Count Mobile Application,” SEAJOM Southeast Asia J. Midwifery, vol. 8, no. 2, pp. 45–54, 2022, doi: 10.36749/seajom.v8i2.184.
[17] R. J. Derman et al., “RAPIDIRON: Reducing Anaemia in Pregnancy in India—a 3-arm, randomized-controlled trial comparing the effectiveness of oral iron with single-dose intravenous iron in the treatment of iron deficiency anaemia in pregnant women and reducing low birth weight d,” Trials, vol. 22, no. 1, pp. 1–16, 2021, doi: 10.1186/s13063-021-05549-2.
[18] S. Jain and N. Acharya, “Fetal Wellbeing Monitoring : A Review Article,” vol. 14, no. 9, pp. 1–7, 2022, doi: 10.7759/cureus.29039.
[19] R. Mossayebnezhad, M. Niknami, S. Pakseresht, and E. K. Leili, “Estimation of Fetal Weight by Clinical Methods and Ultrasonography and Comparing With Actual Birth Weight,” J. Holist. Nurs. Midwifery, vol. 31, no. 4, pp. 219–226, 2021, doi: 10.32598/JHNM.31.4.2055.
[20] G. Doulaveris et al., “Fetal abdominal circumference in the second trimester and prediction of small for gestational age at birth,” J. Matern. Neonatal Med., vol. 33, no. 14, pp. 2415–2421, 2020, doi: 10.1080/14767058.2018.1554039.
[21] L. J. Salomon et al., “ISUOG Practice Guidelines: ultrasound assessment of fetal biometry and growth,” Ultrasound Obstet. Gynecol., vol. 53, no. 6, pp. 715–723, Jun. 2019, doi: 10.1002/uog.20272.
[22] R. J. Knupp, W. W. Andrews, and A. T. N. Tita, “The future of electronic fetal monitoring,” Best Pract. Res. Clin. Obstet. Gynaecol., vol. 67, no. April, pp. 44–52, 2020, doi: 10.1016/j.bpobgyn.2020.02.004.
[23] A. Syamsinar Asmi, M. Tahir Kasnawi, A. Agustang, and A. Yani, “Sociocultural Transformation in Efforts to Reduce Mortality of Infants in Bone Regency, Indonesia,” Syst. Rev. Pharm., vol. 11, no. 10, pp. 762–765, 2020, doi: 10.31838/srp.2020.10.113.
[24] S. Jain and N. Acharya, “Fetal Wellbeing Monitoring – A Review Article,” Cureus, Sep. 2022, doi: 10.7759/cureus.29039.
[25] J. Fu et al., “Associations between maternal exposure to air pollution during pregnancy and trajectories of infant growth: A birth cohort study,” Ecotoxicol. Environ. Saf., vol. 269, no. December 2023, 2024, doi: 10.1016/j.ecoenv.2023.115792.
[26] P. Utami, H. Zulkifli, and H. Hasyim, “Analysis Determination of Estimated Fetal Weight on Pregnant Mothers,” J. Ilm. Kesehat., vol. 3, no. 3, pp. 217–227, 2021, doi: 10.36590/jika.v3i3.207.
[27] C. Poggi and M. Palavecino, “Ultrasound principles and instrumentation,” Surg. Open Sci., vol. 18, no. March, pp. 123–128, 2024, doi: 10.1016/j.sopen.2024.02.005.
[28] Y. Tanaka, K. Sumi, I. Iwata, and T. Sakamoto, “Complex Number Assignment in the Topology Method for Heartbeat Interval Estimation Using Millimeter-Wave Radar,” IEEE Sensors Lett., vol. 8, no. 3, pp. 1–4, 2024, doi: 10.1109/LSENS.2024.3364393.
[29] P. Kamankesh and Z. Ghayedi, “The Effect of Herbal Drinks (Moringa, Turmeric, Lemongrass) on Uterine Involution in Post-Partum Women,” J. Sci. Eng. Elit., vol. 12, no. 47, pp. 84–92, 2023, doi: 10.26655/JMCHEMSCI.2024.6.8.
[30] N. Lee, Y. H. Bae, S. S. M. Fong, and W. H. Lee, “Effects of Pilates on inter-recti distance, thickness of rectus abdominis, waist circumference and abdominal muscle endurance in primiparous women,” BMC Womens. Health, vol. 23, no. 1, pp. 1–11, 2023, doi: 10.1186/s12905-023-02775-5.
[31] Y. Lu, X. Fu, F. Chen, and K. K. L. Wong, “Prediction of fetal weight at varying gestational age in the absence of ultrasound examination using ensemble learning,” Artif. Intell. Med., vol. 102, 2020, doi: 10.1016/j.artmed.2019.101748.
Copyright (c) 2025 Ayu Dini Megantari (Author)
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-ShareAlikel 4.0 International (CC BY-SA 4.0) that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
