The quality of evidence for the comparison of reduced schedule of antenatal appointments versus standard schedule of antenatal appointments ranged from very low to moderate, with most of the evidence being of a very low quality. See the literature search strategy in appendix B and study selection flow chart in appendix C. One RCT ( Butler 2019) compared a reduced frequency antenatal care model (schedule of 8 clinic appointments, 6 virtual appointments (consisting of home blood pressure measurement, fetal heart rate testing) and access to an online prenatal care community) to the standard model of care (a schedule of 12 clinic visits).įive studies were conducted in the US ( Binstock 1995, Butler 2019, McDuffie 1996 & 1997, and Walker 1997) and 2 studies were conducted in the UK ( Jewell 2000 and Sikorski 1996). In all studies, women were given the option to have additional antenatal care appointments as needed. In 2 RCTs ( Jewell 2000 and Sikorski 1996) the number of appointments in the reduced schedule was altered according to parity. The number of appointments comprising a reduced number of appointments and the number of appointments comprising standard care varied: 1 RCT compared a 6/7-visit schedule to a 13 visit schedule ( Sikorski 1996) 1 RCT compared an 8-visit schedule to a 13-visit schedule ( Binstock 1995) 1 RCT compared an 8-visit schedule to a 14-visit schedule ( Walker 1997) 1 RCT compared a 9-visit schedule to a 14-visit schedule ( McDuffie 1996, 1997) 1 RCT compared a 7/8-visit schedule to a 13-visit schedule ( Jewell 2000). The included studies are summarised in Table 2 Seven studies reporting 6 randomised controlled trials (RCTs) were identified for this review, all of which examined whether a reduced number of antenatal appointments is as effective as standard care ( Binstock 1995, Butler 2019, Jewell 2000, McDuffie 1996 & 1997, Sikorski 1996, Walker 1997).
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