At the end of last month, Purdue University researchers in Indiana, USA announced the development of an app and wearable technology, to enable pregnant women detect their susceptibility to pre-eclampsia. Pre-eclampsia is a life-threatening condition characterized by high blood pressure and excessive protein leakage from the body, usually beginning after 20 weeks of pregnancy. The only cure for pre-eclampsia is delivery of the fetus and placenta, which is why when the condition is severe, or begins very early in pregnancy, babies are delivered prematurely to save the life of the mother. To date, there is no definitive way to predict which women will develop pre-eclampsia for sure, although we can determine risk status from an individual’s medical and family history.
Purdue researchers explain that the device is composed of a body position sensor on the abdomen and a blood pressure cuff on the wrist. Both are connected to a smartphone. The app on the phone guides users as to how to calculate blood pressure correctly. The readings are to be taken lying on the side and on the back. Previously published work has apparently shown that an acute elevation in blood pressure when a woman shifts from her side to her back can predict 90% of pre-eclampsia, also known as the supine pressure test. The readings calculate a predictive risk.
Purdue University researchers will begin testing the device as third stage clinical trials this year in rural and marginalized areas of Indianapolis. The hope is that the technology can be disseminated globally, particularly in areas where maternal mortality is high. A major benefit of app related diagnostics is that most people have a smartphone. Globally, smartphone ownership and usage is going up, rising at an extraordinary rate in emerging and developing nations. This allows for remote monitoring of patients not only in rural areas here in the USA, but also in developing regions of the world. Women often forego hospital appointments due to work commitments, cost of transport, or caring of other children. This will allow women to save time and money, and also be monitored. The development and distribution of this technology is also likely to be affordable in low income areas as the kit only involves blood pressure sensors. It’s portable nature also makes it even more suited for rural areas. However, reusability will need to be considered.
Researchers hope the wearable technology and app will help the early prediction of pre-eclampsia. Early prediction can allow for better management of pre-eclampsia in the pregnancy. However, the reduction of premature babies born as a result of pre-eclampsia may be a little more difficult. Managing pre-eclampsia with anti-hypertensives can only be done for so long before delivery is required. In addition, many of these babies suffer from poor growth due to placental insufficiency that can occur with pre-eclampsia. Therefore, premature delivery at times, is to save the fetus. The app however, may be able to extend pregnancy for a few more weeks if it enables disease management to be optimized. One to two more weeks extra in the womb can make a huge difference to these babies. Hopefully the clinical trials produce some positive results!
Now as a next step, we ask what could be done to lower the costs of the implementation of the E-MOTIVE bundle? The most obvious answer is to consider displacing the tens of thousands of disposable plastic drapes with a purpose-built reusable device.
Fortunately one of the obstetricians involved in the E-MOTIVE study, Dr. Justus Hofmeyr, had been innovating around this very issue, designing a tray with wells that could fit under a woman’s buttocks, collect and accurately measure the. blood. This tray, theMaternaWellTraywas conceived as a device that could be sterilized and reused, and is manufactured in South Africa by Umoya.
The Pumani bubbleCPAP was designed to meet this need for Malawi and is now widely available through Maternova. We had a few questions about post-research phases of the Pumani bubbleCPAP which we posed to Jocelyn Brown, inventor of the Pumani bubbleCPAP, and Molly McCabe, Director of Product Management.