Hans van den Heuvel

9 METHODS We conducted a nationwide cross-sectional study using an online survey amongst obstetric care professionals. All hospitals with pregnancy and childbirth care departments in the Netherlands (n=73) were invited to participate in our survey. They were asked to appoint one of their obstetric professionals, dedicated to (remote) pregnancy monitoring, as representative of the department to answer the questions on behalf of the practice. After receiving additional information about the purpose of the study, access was provided to our online SurveyMonkey survey. The survey was sent in November 2018 followed by a maximum of three e-mail reminders. Non-respondents were contacted once more by phone to answer the principal question: Does your center currently offer home- or telemonitoring in pregnancy? The survey was self-developed and was based on expert knowledge of home- and telemonitoring in the Netherlands. A professor of obstetrics, a perinatologist, a hospital- basedmidwife and 2 researchers, all with extensive experience in home-basedmonitoring of risk pregnancies, were involved in its development. It contained a maximum of 44 questions depending on whether home- or telemonitoring was offered. The open and multiple-choice questions addressed four domains: 1. Basic demographics of the respondent; 2. Home- monitoring; 3. Telemonitoring; 4. Advantages and disadvantages of home-and telemonitoring as perceived by the respondent (See Multimedia Appendix 1). Total number of births per year were asked in order to compare hospitals with reference to their size. Regarding the provision of home- or telemonitoring, the year of start and, if applicable, year of discontinuation was asked. We defined our study period from 1995 to 2018. Questions regarding indications, management protocols, and (dis)advantages of the strategies, were asked to be answered with the centers’ practice of year 2018 in mind. In the introduction of our survey, home monitoring was defined as: daily pregnancy monitoring with help of hospital personnel traveling to the pregnant women’s home. Telemonitoring was defined as: daily pregnancy monitoring with help of devices used by the pregnant women at home in absence of hospital personnel (Figure 1). Simple descriptive statistics were used to describe the results. No ethical approval was required for this study because patients were not involved. CURRENT PRACTICE OF HOME-BASED TELEMONITORING IN THE NETHERLANDS 147