Despite encouraging declines in maternal mortality over the last two decades, women in resource-poor areas of the world still bear a disproportionate burden. Worldwide, around 10 million women develop preeclampsia each year and about 10-25% of cases in developing countries lead to death. Women in developing countries bear a disproportionate burden - they are seven times more likely to experience preeclampsia than a woman in developed countries.
Preeclampsia is a disorder defined clinically by hypertension and proteinuria, with or without pathologic edema, and can progress to eclampsia. Eclampsia is a serious condition that can cause seizures, kidney and liver damage, and death. There are currently no ways to accurately predict preeclampsia, but urinalysis and blood pressure readings can be used to diagnose the disorder. In place where resources are scarce, urine dipsticks are used instead of urinalysis, but results are not always reliable.
In response to these problems, Maternova partnered with HOPE Foundation Bangladesh to conduct a study looking at the feasibility of a novel urinalysis technology powered by an Android device and cuboid light box called the uChek device. Funded by Merck for Mothers, the study took place at a rural hospital in Ramu, Cox’s Bazar, Bangladesh, near the country’s border with Myanmar, and aimed to look at whether midwives could effectively use the device to conduct enhanced urinalysis. At the beginning of the study, half of the midwives found the device to be “daunting”, but at the end of the study, all of them agreed that the uChek provided faster and more reliable results. Furthermore, these results showed that these smartphone enabled medical devices could be incorporated with minimal additional training or resources - important considerations in places without a lot of resources.
Devices such as the uChek can prove to be invaluable in early diagnoses of preeclampsia, which in turn can mean many saved lives. Early diagnosis can allow for better planning and preparation; for example, if warning signs are detected at 20 weeks gestation, the device can be programmed to prompt the provider to prescribe the appropriate supplements, frequent antenatal checks, and to plan with an obstetrician for special preparations during and post-delivery. This study adds to the growing body of evidence showing that smartphone technology is becoming an increasingly important tool for medical diagnosis in remote areas.
The BiliDx is a novel system for diagnosing jaundice. The device uniquely meets the Target Product Profile (TPP) developed as part of the NEST 360 initiative in that it allows blood-based testing at the bedside. This initiative is part of an emerging global consensus in the Every Newborn Action Plan that countries need functional WHO level-2 inpatient units to care for "small and sick newborns."
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.