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h1. _Obstech - Tele-CTG_: Conceção e prototipagem dum serviço de telemedicina em obstetrícia
h2. *0. Abstract*
The _Obstech – Tele-CTG_ project aims to conceive and prototype an innovative telemedicine service in the field of obstetrics, focused on remote cardiotocography (CTG) monitoring during pregnancy. Cardiotocography is an essential clinical exam that simultaneously records fetal heart rate and uterine activity, traditionally performed in hospital settings.
This project proposes a hybrid model composed of a portable signal acquisition device and an integrated digital platform with two distinct interfaces: one designed for the pregnant woman (patient-facing) and another for healthcare professionals (clinical-facing). The approach is centered on user interviews and functional mockup development to validate the system's utility and feasibility.
The solution addresses a clear gap in the current market, where existing solutions are either highly reliable but hospital-bound, or accessible but lacking clinical integration and intelligent data analysis. Obstech bridges these two extremes by combining clinical-grade CTG monitoring with a patient-centered digital experience.
*Keywords:* Telemedicine, Obstetrics, Cardiotocography, Remote Monitoring, eHealth, Prototyping
h2. *1. Introduction*
h3. *1.1 What is _Obstech – Tele-CTG_?*
_Obstech – Tele-CTG_ is a telemedicine service designed for remote fetal monitoring through cardiotocography (CTG) in home environments. It consists of a portable or wearable device that captures fetal heart rate and uterine activity signals, combined with a digital platform that transmits and displays this data securely to healthcare providers.
The system operates on a hybrid model: the pregnant woman uses the device at home while her clinical data is continuously available to her medical team through a dedicated professional interface. This eliminates the need for frequent hospital visits while maintaining the clinical quality and continuity of fetal monitoring.
h3. *1.2 The Concept of Remote CTG Monitoring*
Cardiotocography CTG is the simultaneous recording of the fetal heart rate (FHR) and uterine contractions. It is a standard clinical tool used to assess fetal well-being during pregnancy and labor. In its traditional form, CTG requires the pregnant woman to visit a hospital or clinic, where sensors are placed on the abdomen and connected to a monitor.
Remote CTG monitoring refers to the use of portable or wearable sensors to perform CTG outside the clinical setting, typically at home, with data transmitted electronically to healthcare providers. This approach enables continuous or on-demand monitoring, reducing the burden on hospital services and improving access for patients in remote or underserved areas.
h3. *1.3 Project Motivation and Objectives*
The motivation for this project stems from the clear limitations of current CTG monitoring practice:
* Frequent and inconvenient hospital visits for routine monitoring;
* Episodic rather than continuous fetal surveillance;
* Overloaded obstetrics departments;
* Limited autonomy for the pregnant woman;
* Poor access for patients in rural or geographically isolated areas.
The main objectives of _Obstech – Tele-CTG_ are:
* Develop a remote CTG monitoring solution usable in a home environment;
* Review the state of the art and identify gaps in existing solutions;
* Contact relevant stakeholders (pregnant women, obstetricians, nurses) for requirements gathering;
* Design functional mockups of both the patient and clinical interfaces;
* Validate the proposed system's utility, usability, and clinical viability.
h2. *2. Market Assessment Study*
h3. *2.1 Review of Existing Solutions*
A systematic review of existing solutions for remote fetal monitoring was conducted. The solutions were evaluated across five key criteria: home use capability, full CTG measurement (FHR + uterine activity), clinical interface, patient interface, and automatic data analysis.
!Tabela_1.png(300)!
h3. *2.2 Analysis of Available Apps*
Beyond dedicated hardware systems, several mobile applications exist for pregnancy monitoring. These can be broadly grouped into three categories:
* Consumer wellness apps (e.g., baby heartbeat apps): These use the smartphone microphone to detect fetal sounds. They lack clinical accuracy and are not validated for medical use.
* Companion apps for medical devices: Applications paired with CTG devices (e.g., HeraBEAT app, PregnaBit app) that display data from dedicated sensors. These have better accuracy but typically offer limited clinical integration and a basic user experience.
* Hospital platform apps: Web-based or mobile interfaces for clinical staff to access patient monitoring data remotely (e.g., OBIX, Sonicaid). These are clinically robust but are not designed for patient use.
A key finding across all app categories is the consistent absence of a well-designed, patient-centered interface that makes clinical data meaningful and accessible to the pregnant woman without requiring medical expertise.
h3. *2.2 Analysis of Available Apps*
The market analysis reveals a consistent pattern: existing solutions cluster at opposite ends of a spectrum. Clinical systems offer high reliability but require hospital attendance; home devices offer convenience but lack clinical depth and integration.
The identified gaps that _Obstech_ Obstech aims to address are:
* No solution combines full CTG monitoring (FHR + uterine activity) in the home setting with a strong clinical platform;
* Patient-facing interfaces are universally underdeveloped — data is displayed without meaningful context for the pregnant woman;
* Automatic analysis and intelligent alerting is either absent or limited in home-use solutions;
* No solution offers a true hybrid model with continuous bidirectional communication between the patient and the clinical team;
* Digital pregnancy records (a unified 'digital pregnancy booklet') are absent from all reviewed solutions.
These gaps define the innovation space for Obstech and directly inform its differentiating features.
h2. *3. Structure*
h3. *3.1 Requirements Gathering*
Requirements for the Obstech system were gathered through a combination of literature review, analysis of existing solutions, and direct contact with end users and healthcare professionals. The requirements gathering process followed an iterative approach, with initial requirements refined based on stakeholder feedback.
Requirements were classified into functional requirements (what the system must do) and non-functional requirements (how the system must perform), and further divided by interface: patient-facing and clinician-facing.
*Key functional requirements identified*:
* Real-time transmission of CTG data (FHR + uterine activity) from home to clinical platform;
* Patient interface: simplified CTG summaries, digital pregnancy booklet, gestational timeline, exam history;
* Clinical interface: full CTG traces, structured patient history, report generation, multi-patient dashboard, alert system;
* Secure and encrypted data storage and transmission (GDPR compliant);
* Interoperability with existing hospital systems (HL7/FHIR standards).
h3. *3.2 Interviews and Iterations*
h3. *3.3 Final Features and Specifications*
Based on the requirements gathering process and interview iterations, the final feature set for the Obstech prototype is defined as follows:
*Patient Interface (App)*:
Digital pregnancy booklet — unified view of all pregnancy information;
* CTG session results displayed in plain language with visual summaries;
* Gestational timeline showing week-by-week pregnancy progression;
* Exam history and results archive;
* Push notifications for alerts or messages from the clinical team;
* Secure in-app messaging with the healthcare provider.
*Clinical Interface (Web Platform)*:
* Multi-patient dashboard with real-time monitoring status;
* Full CTG trace visualization (cardiotocogram viewer);
* Structured clinical history per patient;
* Automated report generation (exportable PDF);
* Alert system for values outside clinical thresholds;
* Trend analysis and comparison of CTG sessions over time;
* Clinical decision support (pattern flagging, risk indicators).
h3. *3.4 Use Cases*
h3. *3.5 Activity Diagrams*
h2. *4. Design and Functionalities*
h3. *4.1 Mockup Building* - *+CONFIRMAR COM FIGMA + COLOCAR FOTOS!!!+*
Mockups were developed for both the patient-facing mobile application and the clinician-facing web platform. The design process followed a user-centered approach, with mockup iterations informed by the stakeholder interviews described in Section 3.2.
*Patient App — Key screens*:
* Home screen / Dashboard: gestational week, next appointment, quick access to recent CTG result;
* CTG Result screen: visual summary of last session with plain-language interpretation;
* Pregnancy Booklet: timeline with all exams, results, and clinical notes;
* Notifications: alerts and messages from the clinical team;
* Profile & Settings: personal data, device pairing, language preferences.
*Clinical Platform — Key screens*:
* Patient list dashboard: all monitored patients with status indicators;
* Patient profile: full clinical history, gestational record, device status;
* CTG viewer: interactive trace visualization with annotation tools;
* Alerts panel: flagged events requiring clinical attention;
* Reports: generation, preview, and export of clinical reports.
h2. *0. Abstract*
The _Obstech – Tele-CTG_ project aims to conceive and prototype an innovative telemedicine service in the field of obstetrics, focused on remote cardiotocography (CTG) monitoring during pregnancy. Cardiotocography is an essential clinical exam that simultaneously records fetal heart rate and uterine activity, traditionally performed in hospital settings.
This project proposes a hybrid model composed of a portable signal acquisition device and an integrated digital platform with two distinct interfaces: one designed for the pregnant woman (patient-facing) and another for healthcare professionals (clinical-facing). The approach is centered on user interviews and functional mockup development to validate the system's utility and feasibility.
The solution addresses a clear gap in the current market, where existing solutions are either highly reliable but hospital-bound, or accessible but lacking clinical integration and intelligent data analysis. Obstech bridges these two extremes by combining clinical-grade CTG monitoring with a patient-centered digital experience.
*Keywords:* Telemedicine, Obstetrics, Cardiotocography, Remote Monitoring, eHealth, Prototyping
h2. *1. Introduction*
h3. *1.1 What is _Obstech – Tele-CTG_?*
_Obstech – Tele-CTG_ is a telemedicine service designed for remote fetal monitoring through cardiotocography (CTG) in home environments. It consists of a portable or wearable device that captures fetal heart rate and uterine activity signals, combined with a digital platform that transmits and displays this data securely to healthcare providers.
The system operates on a hybrid model: the pregnant woman uses the device at home while her clinical data is continuously available to her medical team through a dedicated professional interface. This eliminates the need for frequent hospital visits while maintaining the clinical quality and continuity of fetal monitoring.
h3. *1.2 The Concept of Remote CTG Monitoring*
Cardiotocography CTG is the simultaneous recording of the fetal heart rate (FHR) and uterine contractions. It is a standard clinical tool used to assess fetal well-being during pregnancy and labor. In its traditional form, CTG requires the pregnant woman to visit a hospital or clinic, where sensors are placed on the abdomen and connected to a monitor.
Remote CTG monitoring refers to the use of portable or wearable sensors to perform CTG outside the clinical setting, typically at home, with data transmitted electronically to healthcare providers. This approach enables continuous or on-demand monitoring, reducing the burden on hospital services and improving access for patients in remote or underserved areas.
h3. *1.3 Project Motivation and Objectives*
The motivation for this project stems from the clear limitations of current CTG monitoring practice:
* Frequent and inconvenient hospital visits for routine monitoring;
* Episodic rather than continuous fetal surveillance;
* Overloaded obstetrics departments;
* Limited autonomy for the pregnant woman;
* Poor access for patients in rural or geographically isolated areas.
The main objectives of _Obstech – Tele-CTG_ are:
* Develop a remote CTG monitoring solution usable in a home environment;
* Review the state of the art and identify gaps in existing solutions;
* Contact relevant stakeholders (pregnant women, obstetricians, nurses) for requirements gathering;
* Design functional mockups of both the patient and clinical interfaces;
* Validate the proposed system's utility, usability, and clinical viability.
h2. *2. Market Assessment Study*
h3. *2.1 Review of Existing Solutions*
A systematic review of existing solutions for remote fetal monitoring was conducted. The solutions were evaluated across five key criteria: home use capability, full CTG measurement (FHR + uterine activity), clinical interface, patient interface, and automatic data analysis.
!Tabela_1.png(300)!
h3. *2.2 Analysis of Available Apps*
Beyond dedicated hardware systems, several mobile applications exist for pregnancy monitoring. These can be broadly grouped into three categories:
* Consumer wellness apps (e.g., baby heartbeat apps): These use the smartphone microphone to detect fetal sounds. They lack clinical accuracy and are not validated for medical use.
* Companion apps for medical devices: Applications paired with CTG devices (e.g., HeraBEAT app, PregnaBit app) that display data from dedicated sensors. These have better accuracy but typically offer limited clinical integration and a basic user experience.
* Hospital platform apps: Web-based or mobile interfaces for clinical staff to access patient monitoring data remotely (e.g., OBIX, Sonicaid). These are clinically robust but are not designed for patient use.
A key finding across all app categories is the consistent absence of a well-designed, patient-centered interface that makes clinical data meaningful and accessible to the pregnant woman without requiring medical expertise.
h3. *2.2 Analysis of Available Apps*
The market analysis reveals a consistent pattern: existing solutions cluster at opposite ends of a spectrum. Clinical systems offer high reliability but require hospital attendance; home devices offer convenience but lack clinical depth and integration.
The identified gaps that _Obstech_ Obstech aims to address are:
* No solution combines full CTG monitoring (FHR + uterine activity) in the home setting with a strong clinical platform;
* Patient-facing interfaces are universally underdeveloped — data is displayed without meaningful context for the pregnant woman;
* Automatic analysis and intelligent alerting is either absent or limited in home-use solutions;
* No solution offers a true hybrid model with continuous bidirectional communication between the patient and the clinical team;
* Digital pregnancy records (a unified 'digital pregnancy booklet') are absent from all reviewed solutions.
These gaps define the innovation space for Obstech and directly inform its differentiating features.
h2. *3. Structure*
h3. *3.1 Requirements Gathering*
Requirements for the Obstech system were gathered through a combination of literature review, analysis of existing solutions, and direct contact with end users and healthcare professionals. The requirements gathering process followed an iterative approach, with initial requirements refined based on stakeholder feedback.
Requirements were classified into functional requirements (what the system must do) and non-functional requirements (how the system must perform), and further divided by interface: patient-facing and clinician-facing.
*Key functional requirements identified*:
* Real-time transmission of CTG data (FHR + uterine activity) from home to clinical platform;
* Patient interface: simplified CTG summaries, digital pregnancy booklet, gestational timeline, exam history;
* Clinical interface: full CTG traces, structured patient history, report generation, multi-patient dashboard, alert system;
* Secure and encrypted data storage and transmission (GDPR compliant);
* Interoperability with existing hospital systems (HL7/FHIR standards).
h3. *3.2 Interviews and Iterations*
h3. *3.3 Final Features and Specifications*
Based on the requirements gathering process and interview iterations, the final feature set for the Obstech prototype is defined as follows:
*Patient Interface (App)*:
Digital pregnancy booklet — unified view of all pregnancy information;
* CTG session results displayed in plain language with visual summaries;
* Gestational timeline showing week-by-week pregnancy progression;
* Exam history and results archive;
* Push notifications for alerts or messages from the clinical team;
* Secure in-app messaging with the healthcare provider.
*Clinical Interface (Web Platform)*:
* Multi-patient dashboard with real-time monitoring status;
* Full CTG trace visualization (cardiotocogram viewer);
* Structured clinical history per patient;
* Automated report generation (exportable PDF);
* Alert system for values outside clinical thresholds;
* Trend analysis and comparison of CTG sessions over time;
* Clinical decision support (pattern flagging, risk indicators).
h3. *3.4 Use Cases*
h3. *3.5 Activity Diagrams*
h2. *4. Design and Functionalities*
h3. *4.1 Mockup Building* - *+CONFIRMAR COM FIGMA + COLOCAR FOTOS!!!+*
Mockups were developed for both the patient-facing mobile application and the clinician-facing web platform. The design process followed a user-centered approach, with mockup iterations informed by the stakeholder interviews described in Section 3.2.
*Patient App — Key screens*:
* Home screen / Dashboard: gestational week, next appointment, quick access to recent CTG result;
* CTG Result screen: visual summary of last session with plain-language interpretation;
* Pregnancy Booklet: timeline with all exams, results, and clinical notes;
* Notifications: alerts and messages from the clinical team;
* Profile & Settings: personal data, device pairing, language preferences.
*Clinical Platform — Key screens*:
* Patient list dashboard: all monitored patients with status indicators;
* Patient profile: full clinical history, gestational record, device status;
* CTG viewer: interactive trace visualization with annotation tools;
* Alerts panel: flagged events requiring clinical attention;
* Reports: generation, preview, and export of clinical reports.