Telemedicine support for high-risk pregnancies under a shortage of specialists

Introduction. Access to specialized medical care for pregnant women is unevenly distributed across the country. For high-risk pregnant women, this means delayed care or the need for urgent transportation. Telemedicine technologies can partially bridge this gap by providing monitoring and timely decision-making without the need for an in-person visit to a specialist.
The objective. To analyze the volume, dynamics, geographic and nosological structure of telemedicine consultations for pregnant women performed at the Ural Research Institute for Maternal and Child Care in 2023–2025, and to assess the role of telemedicine in compensating for the shortage of specialists in remote areas of the Sverdlovsk region and the Ural Federal District.
Materials and methods. A retrospective analysis of the institute’s telemedicine consultation registry was performed. The consultation served as the unit of analysis. The format, territorial distribution, nosological profile and patient routing were assessed. The detailed clinical and organizational analysis included 1857 consultations with a complete set. A descriptive series of 11 federal consultations from 2025 was reviewed separately.
Results. Over 2023–2025, the annual number of telemedicine and remote consultations increased from 659 to 1531, with 3617 consultations performed over the three-year period. In 2025 the Northern administrative district accounted for about 65 % of consultations (723 of 1113), with the town of Serov alone accounting for 510 (46 %). Among consultations with a recorded diagnosis, carbohydrate metabolism disorders predominated: gestational diabetes mellitus accounted for 85.6 %, nearly half of which involved diet-controlled management. Endocrinologists performed 193 consultations in 2025 (about 17 %), which is particularly important for areas without a staff endocrinologist (Krasnoturyinsk, Ivdel, Severouralsk). After teleconsultation, 70–75 % of patients were referred to the institute for delivery and about 10 % for an in-person consultation.
Conclusion. Telemedicine support provides high-risk pregnant women with access to specialized federal-level care regardless of remoteness and local staffing and contributes to selecting patients for delivery at a tertiary center. The predominance of gestational diabetes mellitus defines the endocrinological focus of this work and supports the development of remote glycemic monitoring, the evidence base of which in this condition remains insufficient.

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