Innovations in vital signs measurement for the detection of hypertension and shock in pregnancy

Abstract

Approximately 820 women die in pregnancy and childbirth every day worldwide, with 99% of these occurring in low-resource settings. The most common causes of maternal mortality are haemorrhage, sepsis and hypertensive disorders. There are established, effective solutions to these complications, however challenges remain in identifying who is at greatest risk and ensuring that interventions are delivered early when they have the greatest potential to benefit. Measuring vital signs is the first step in identifying women at risk. Overstretched or poorly trained staff and inadequate access to accurate, reliable equipment to measure vital signs can potentially result in delayed treatment initiation. Early warning systems may help alert users to identify patients at risk, especially where novel technologies can improve usability by automating calculations and alerting users to abnormalities. This may be of greatest benefit in under-resourced settings where task-sharing is common and early identification of complications can allow for prioritisation of life-saving interventions. This paper highlights the challenges of accurate vital sign measurement in pregnancy and identifies innovations which may improve detection of pregnancy complications.

Implementing a community-level intervention to control hypertensive disorders in pregnancy using village health workers: lessons learned

“…The trained VHWs using the blood pressure-measuring device and house-to-house visits help to identify, refer, and follow up pregnant women at risk of pre-eclampsia and eclampsia. Overstretched health facility-based staff with inadequate access to accurate and reliable equipment to measure vital signs causes delayed treatment initiation for pre-eclampsia and eclampsia in resource-poor settings [20]. There are however policy issues to overcome in LMICs for level 1 CHWs to take part in managing hypertension in pregnancy [26,28].…”

“…Early identification and sorting of cases of pre-eclampsia and eclampsia can avert close to 50% of maternal and fetal deaths that occur because of the diseases [ 18 – 20 ]. Innovative approaches to improve the demand for and coverage of health facility-based interventions for pre-eclampsia and eclampsia are needed [ 13 , 19 ].…”

Low-Cost Contact Thermometry for Screening and Monitoring During the COVID-19 Pandemic

“…Non-contact and contact thermometry solutions work on different sets of principles and in the COVID-19 pandemic, both have distinct applications. For instance, non-contact thermometers are used to abide by workplace screening guidelines for which the team has demonstrated a distinct, proof-of-concept solution through [19], guidelines are available for temperature screening for pregnant women diagnosed with COVID-19 [7] and for screening during maternity in general [11], for which contact thermometry might offer pertinent solutions.…”

“…Maternal temperature measurement and monitoring have been studied and reported in clinical studies [10]. Temperature, a basic vital sign recommended for monitoring during pregnancy [11] is also indicated for pregnant women diagnosed with COVID-19 infection [7].…”

Comprehensive pregnancy monitoring with a network of wireless, soft, and flexible sensors in high- and low-resource health settings

“…Accordingly, ∼295,000 women die as a result of childbirth complications each year, with 94% of these deaths occurring in low-and middle-income countries (LMICs) (3). The most common causes of maternal morbidity and mortalityhemorrhage, hypertensive disorders, infection, and sepsis-are often preceded by predictable vital signs perturbations in both high-resource and low-resource settings, and early intervention is key to improving outcomes (4)(5)(6)(7)(8)(9).…”