Maternova blog
Detecting pre-eclampsia:a low-cost blood pressure cuff
Mon, 03/08/2010 - 08:19Eclampsia is a major cause of death in the developing world. Put in a layperson's terms, pre-eclampsia is a disease of pregnancy with somewhat unclear etiology. Untreated, it can lead to eclampsia or extremely high blood pressure that results in seizures and eventually shock and death. We have posted magnesium sulfate which is a compound used to treat eclampsia and save a mother's life. However, we will be covering a series of early stage devices that can help to predict and diagnose pre-eclampsia.
Some in-depth research led us to Andy Shennan in the UK. Dr. Shennan is an obstetrician with a long-term interest in pre-eclampsia and he is also Director of Maternity Worldwide and researcher at the Maternal & Fetal Research Unit, King's College, London. As it turns out, he and his team are actually developing a very low-cost blood pressure monitoring device suitable for very low-resource settings. They've tested (and validated) the device in Ethiopia and Tanzania and are currently determining how to translate accurate readings on the device into actionable decisions in diagnosing and treating pre-eclampsia.
Like so many of the devices featured, the technology in this blood pressure cuff, called Microlife, actually comes from experiments in space. The Microlife device uses oscillometry rather than Doppler. Dr. Shennan notes that beyond the requirements of low-resource settings, a fundamental problem with pre-eclampsia detection is that Doppler is not effective due to changes in haemodynamics in women suffering from pre-eclampsia. What he's saying is that even if you actually had a high-tech doppler in a low-reource setting, you still would not be accurately detecting pre-eclampsia. The low-cost, solar-powered device being developed runs with a manual pump and needs simply a battery. The team has funding from the EU and will be testing this incredibly exciting device in 5 countries. Stay tuned for more information, photos and results of clinical testing.
Blantyre Hot cots: an innovation story from Kenya to Malawi then Texas to Rwanda and back
Thu, 03/04/2010 - 13:39
The 'Beyond Traditional Borders' program at Rice University has developed a number of innovations for maternal and neonatal survival. Among the more interesting technologies is the Blantyre hot cot. This is a short story about an innovation developed by a team of students in Kenya, discovered by Rice students in Blantyre, Malawi and then re-tooled to be cheaper, use less energy and keep an infant optimally warm and supplied with oxygen. Essentially the stand-alone unit consists of a wood box with a plexiglass top and 4 electric lightbulbs to warm the baby from below. Experiments with air flow and temperature (as well as carbon dioxide buildup) allowed the design to be re-engineered and costs reduced. The hot cot has already been field tested in multiple countries, is in use in Nicaragua, Malawi and Swaziland while the team tests a new iteration will be tested in July 2010. The Rice program is experimenting with pairing this innovaiton with a set of cheap UV lights to treat infants for jaundice. We will follow these stories as they develop.
The simple wood, plexiglass and light hot cot apparently costs just $50 and could be made in most settings. We're interested in following the distribution model here-- wondering if the team will charge for the 'plans' or develop a non-profit to help set up small manufacturing units in high-mortality countries. In the countries where they've already instituted some working prototypes it sounds as though demand is high for more.
Science and its black boxes
Tue, 03/02/2010 - 20:21
A pretty great snippet from Louis Menand in this week's New Yorker... granted the article has nothing to do with maternal health and yet it is so descriptive:
Science, particularly medical science, is not a skyscraper made of Lucite. It is a field strewn with black boxes.
photo credit: javcon on flickr Sept 2009.
Shades of red: WHO's hemoglobin color scale
Mon, 02/15/2010 - 20:48
Anemia is an underlying or contributing cause of much of maternal mortality. Put in a layperson's terms, anemia means that there are fewer than normal red blood cells in the blood, and thus less oxygen being carried to organs. A person's blood changes color based in the level of anemia--the lighter the color the more severe the anemia. Based on these simple principles, a color scale was developed to correspond to color of the blood at different levels of anemia (mild, moderate, marked, severe or critical). This device was developed by WHO and worked on for a while by PATH as well. Interestingly, it is a simple outcome-- paper and color--but the process to develop the card was more complex and required sophisticated color printing, a special absorptive paper that rapidly and uniformly stains with a drop of blood, color analysis and clinical tests. 
Hilary supports maternal health: cheat sheet
Thu, 02/11/2010 - 15:37
What is the bottom line on Obama support for maternal health in the administration's Global Health Initiative?
In five words, increased attention to maternal health.
- $593.5 million for reproductive health assistance
- $549 million for maternal health and child survival programs
- $5M increase to UNFPA to $55 million.
Secretary of State Hillary Clinton said that investing in women—including by helping them time and space their pregnancies and by providing pregnancy-related care—“is essential to the prosperity and opportunity of all, to the stability of families and communities, and the sustainability and development of nations.“ Much of the backup for the arguments surrounding the Administration's support for maternal health comes from the new AGI/UNFPA report, Adding it Up. We will cover this report in detail in upcoming posts, but suffice it to say that only half of the 123 million women who give birth each year have access to skilled care.