Study of Fetal Health Outcomes: Working With a Missouri E-telehealth Platform (The SHOW-ME Study)

The goal of this clinical trial is to evaluate the potential benefit to patients and providers from using the remote fetal-monitoring system NUVO along with its app to allow for pregnant patients requiring weekly non-stress testing to do so from their homes. The main questions the investigators are looking to answer are: What effect does the NUVO remote fetal monitoring system have on patient/provider satisfaction? What is the cost savings (both direct and indirect) from using a remote fetal monitoring system as opposed to in-person testing for both the patient and the provider? Researchers will compare the survey responses by both patients and providers for pre and post implementation of the NUVO fetal monitoring system to the survey responses of patients and providers who used the traditional in-clinic method to evaluate satisfaction and cost savings. Participants will: Answer pre-implementation surveys before undergoing the trial Be randomly assigned to do either fetal testing at-home or in-clinic once or twice weekly as up to the provider Before hospital discharge or within the last office visit participants will be given a post-implementation survey

Inclusion Criteria * English Speaking * \> 18 years of age * Singleton gestation * Missouri Medicaid as primary insurance (paid by study), offered to patients with private insurance for self-pay * Requires antenatal testing between 32-40 weeks according to institutional policies * One of the following indications for fetal NST: * Gestational diabetes * Well-controlled type II diabetes * Chronic hypertension without evidence of placental insufficiency * Advanced maternal age * Obesity (as defined as BMI \>30 and \ 30 * Co-existing fetal complications: FGR, placenta or vasa previa, fetal chromosomal or structural anomaly, recent (within a week) fetal testing of a BPP \< 8/10 prior to enrollment * Intention to transfer care to different provider during the pregnancy * Currently institutionalized or incarcerated * Inability to consent for oneself * \