Stillbirth: bringing high-tech surveillance to the womb

Published on 6 July 2010

What's the problem and who does it affect?

Stillbirth: a tragic loss at the beginning of life

Around 11 babies are stillborn every day in the UK, bringing lasting distress to the bereaved parents.¹ Feelings of shock, grief, loss, numbness, anger and guilt are all common, as is depression.

Parents face difficult decisions – about whether to see or hold their baby, for example, and whether they would like a post-mortem. They must also register the stillbirth and may choose to arrange a funeral. The loss of a stillborn baby can be truly heartbreaking.

For many parents, the tragic death of their baby comes completely out of the blue and more than half of stillbirths remain unexplained.¹

However, some women are known to be at risk of having a stillborn child, because of conditions they suffer during pregnancy. These conditions include pre-eclampsia (which is characterised by high blood pressure), obstetric cholestasis (which causes itchy skin), diabetes and obesity. Babies with intrauterine growth restriction, who grow unusually slowly in the womb, are also at increased risk of stillbirth.

Pregnant women can find it difficult to cope if they know they are at increased risk of having a stillbirth. We urgently need better ways to monitor the wellbeing of their babies.

What is the project trying to achieve?

Assessing babies’ movements in the womb

When a baby dies in the womb, or during delivery, after 24 weeks of pregnancy, it is called a stillbirth. Many women say that the pattern of their baby’s movement changed in the days running up to the stillbirth, that they didn’t feel their baby move around or kick as much as usual.

The researchers therefore believe that careful monitoring of a baby’s movements in the womb might help predict which babies are most at risk of being stillborn. They are in the early stages of developing a new fetal surveillance system.

In this project, the researchers are taking one-minute-long ultrasound scans of around 100 healthy women, who are five to six months pregnant, and recording what they see on DVD. The scans provide moving pictures of the babies in the womb.

The researchers are assessing whether it is possible to recognise and analyse the babies’ movements using state-of-the-art computer programs, which incorporate pattern-recognition software. Similar software is already used widely for other purposes –when analysing CCTV footage from security surveillance systems, for example, and for recognising a person’s face or voice at high-security installations.

What are the researchers' credentials?

The project leader, Dr Stephen Ong, is a consultant at the Royal Jubilee Maternity Hospital in Belfast. Dr Ong has a strong background in studying blood pressure problems and small babies who are at risk of stillbirth.

The Royal Jubilee Maternity Hospital cares for women with high-risk pregnancies who are referred to them from other hospitals across the region. The hospital is actively involved in research to assess fetal wellbeing.

For this project, Dr Ong has joined forces with Dr Fatih Kurugollu, an experienced software engineer who has worked extensively on security surveillance systems. Dr Kurugollu is based at Queen’s University Belfast, which has a vibrant engineering department, with considerable experience of research into automated video surveillance. Dr Joan Condell is from the University of Ulster and has recently joined the team. She is a specialist in analysing movement.

The combined skills of an obstetrician and security surveillance experts are ideal for the creation of a novel fetal surveillance system that uses pattern recognition software to monitor a baby’s movement in the womb.

Who stands to benefit from this research and how?

Mobile surveillance of babies in the womb

The researchers hope to develop a new fetal surveillance system, to help monitor the wellbeing of babies in the womb. They believe the system might provide an early warning if a baby is at risk of stillbirth. In some cases, this might allow doctors to intervene in a way that could save the baby’s life – by delivering the baby early, for example.

The work is in its early stages. Ultimately, the researchers hope to develop a mobile device, which pregnant women could use in their own homes. They envisage relaying data from the device wirelessly to a computer.

Around one in 200 babies are stillborn in the UK.¹ Pregnant women who have already experienced a stillbirth, and women who are thought to be at high risk, stand to benefit most from the new surveillance system. This includes the five per cent of pregnant women who suffer pre-eclampsia (with high blood pressure), the three per cent whose babies have restricted growth, the four per cent with diabetes and the one per cent with obstetric cholestasis.²

References

1. Confidential Enquiry into Maternal and Child Health, Perinatal Mortality 2007, June 2009. http://www.cmace.org.uk/getattachment/1d2c0ebc-d2aa-4131-98ed-56bf8269e529/Perinatal-Mortality-2007.aspx
2. High risk pregnancy. Management options. Edited by DK James. 2006.