Last month, a new neonatal resuscitation invention was launched in Uganda… a month later, the device has been launched in the UK and it looks like it could spread further afield. The BabySaver, a device pioneered by Professor Andrew Weeks at Liverpool Women’s NHS Foundation Trust, is the result of three continents partnering together to improve neonatal survival. It is a specialized support device to be delivered at the bedside within the first minute of life.
Approximately 7000 newborns die every day. Most are preventable and many die due to lack of vital life-saving equipment. The BabySaver is composed of plastic and is made up of an upper and lower tray which can hold important equipment, such as a stethoscope and suction device. One of the trays can be placed in between the mother’s legs, so that the baby can be placed on the tray as soon as its born and resuscitated there if needs be. This means the umbilical cord can remain intact and the baby remains close to its mother. When babies struggle straight after birth, the cord is cut quickly and they are moved away from their mother to be resuscitated. Therefore, these babies do not benefit from delayed cord clamping. The WHO advises that cord clamping should be delayed for two to three minutes after the baby has been born, mainly to reduce the risk of iron-deficiency anaemia, infections and various other illnesses. Delayed cord clamping has even more benefits for premature babies (often the ones that are whisked away to be resuscitated), whereby delaying clamping by 30 to 120 seconds reduces anaemia, meaning fewer transfusions, and also results in less intraventricular haemorrhage (bleeding into the ventricles of the brain). The cord also provides oxygen to the baby until the baby can breathe on its own prior to the placenta detaching. Therefore, the cord should not really be cut until the baby has been resuscitated.
Resuscitation after birth usually occurs away from the bedside, and so the introduction of BabySaver will now change the way this occurs. Mothers also tend to become very distressed when their child is taken away to be resuscitated, and usually the midwife accompanies the baby, leaving the mother alone. Again, BabySaver means this does not have to occur. Another huge advantage is how cheap the product is to produce, which means that BabySaver can be scaled easily and quickly. It costs about $50 to produce, significantly cheaper than conventional resuscitaires which cost around $15,000. It also does not require electricity to function which is another advantage for those centers based in rural areas or in cities where power outages happen often. It is not technically complex either, making training simple. More importantly, Professor week’s team appears to have developed and iterated the model with healthcare staff in Uganda - vital when developing health innovations.
Although the numbers are still small, early studies within the UK, USA and Canada have shown that neonatal bedside resuscitation with the cord intact is safe and effective. However, concerns around ergonomics and space during resuscitation with an intact cord at the bedside have been brought up by healthcare professionals. Training and protocols guiding neonatal resuscitation in a hospital environment involve clamping the cord, so this new method highlights the need to train professionals with the cord intact.
BabySaver was officially launched in Uganda last month and further testing will now take place to refine it. We are looking forward to seeing how such a simple device can transform neonatal care.
By Shreya Patel
Photo Credit: Jaap Vermeulen, Jacoplane, Wikipedia
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.