Development of Home Telemetry System using the Internet for High-risk Pregnancy

在高危妊娠的处理中，长期持续监测胎儿心率（FHR）对降低围产儿死亡率和发病率至关重要。在香川医学院的围产期中心，利用互联网，我们开发了连接家庭和医疗设施的产妇管理系统以及在诊所和医院之间运行的网络系统。有了这个系统，FHR和子宫收缩以及胎儿运动可以随时从患者家中或其他医疗机构通过互联网轻松自动地传输到医院。基本系统由FHR监控系统、Windows pc和分析软件组成。对于产妇管理系统，我们开发了便携式FHR监测仪。这种显示器是专为便于在家中使用而设计的。考虑到目前医疗机构的FHR监测系统，该网络系统具有两种使用方式。一种方法是使用从FHR监测器直接传输的FHR数据，另一种方法是使用来自中央监测系统的FHR数据。这些数据以ASCII文本文件格式通过商业网络网关自动从患者家中或其他设施传输到INTERNET。产科医生可以在任何地方，甚至在医院外，通过互联网以电子邮件的形式轻松获取CTG数据。CTG数据显示在CRT上，并自动诊断。利用该系统，不仅可以在一个医院或一个地区社区内，而且可以在任何遥远的医院内建立网络，共享医疗数据，从而实现对高危患者的管理。该系统使理想的围产期管理系统的实现成为可能。

In the management of the high-risk pregnancy, the long term continuous fetal heart rate (FHR) monitoring is most important to reduce the perinatal mortality and morbidity. In the perinatal center at Kagawa Medical School, with use of internet, we developed the maternal management system which connects homes and medical facilities and the network system which runs among clinics and hospitals. With this system, FHR and uterine contractions as well as fetal movements can easily and automatically be transmitted to the hospital through INTERNET from the patient's home or from other medical facilities at any time.The basic system is composed of FHR monitor system, Windows'PC and analyzing software. For the maternal management system, we developed a portable FHR monitor. This monitor is specially designed for easy-use at home. The network system is capable to be used in two ways, considering present FHR monitoring system in medical facilities. One is with the use of FHR data that is directly transmitted from FHR monitor and the other method uses FHR data from the central monitoring system. These data are automatically transmitted from patient's home or from other facilities into INTERNET as ASCII text file format through the gateway of the commercial network.The obstetrician can easily get the CTG data as E-MAIL through INTERNET from anywhere, even out side of the hospital. The CTG data are displayd on the CRT and automatically diagnosed. Using this system, it has become possible to manage the high-risk patient, not only within one hospital or in one regional community but also in any distant hospitals as we can construct network and share medical data. This system makes it possible to realize an ideal perinatal managing system.