Touching Lives - February 2007
New monitor to make pregnancy safer
Every year, around 700,000 women give birth in the UK. During pregnancy, mothers need to be monitored so that doctors can make sure both they and their babies are safe and sound. Now, a novel device is set to change the monitoring of unborn babies, revealing new information to doctors straight from babies hearts. This new technology is the culmination of over 15 years of close collaboration between engineers and doctors at The University of Nottingham. It is this special combination of electronic design expertise with clinical understanding of the unborn child that has led to the creation of this unique monitor, which can check the health of babies particularly at risk in the womb. A baby may be in greater danger if they are known to have a problem with their heart or nervous system, if their growth pattern is below normal, or if their mother has had a previous stillbirth or pregnancy related complication. Babies whose mothers have certain conditions such as diabetes or cholestasis (a build up of bile acids in the bloodstream) are also at greater risk, equally if the pregnancy results in raised blood pressure and the complications of pre-eclampsia.
How to see a baby heart beat
Currently, a test called Doppler ultrasound is used to record babies’ heart rates during pregnancy.While this technique has proven benefits, it needs to be administered by trained professionals and is not suitable for routine, continuous, long-term monitoring. Dr Barrie Hayes-Gill and Dr John Crowe at The University of Nottingham recognised the need for a new technology that would fill these gaps. The researchers say that the key breakthrough in this technology is that it will allow doctors to record fetal heart rate in a non-invasive, unobtrusive manner in the comfort of the mother’s own home over extended time periods, something which no other technology allows. However, it has taken years of hard work and enterprise to achieve this. A big challenge was to ‘pick up’ the baby’s heart beat clearly. The monitor measures the tiny electrical signals made by the unborn baby’s heart through the skin on the mother’s tummy.The electrical reading from the baby’s heart beat is much smaller than that from the mother’s, so the researchers had to find a way to identify the baby’s heart beat without confusing it with signals coming from the mother, or even other electrical equipment in the area.They are now able to clean away all of this other electrical ‘noise’ to see the baby’s heart beat.
Technology in a handbag
The new, state-of-the-art device can gauge both the baby’s and mother’s heart rates, as well as fetal position and maternal activity. The baby’s activity in the uterus, uterine activity and other measures of how the baby’s heart is functioning are also being investigated to add to the capabilities of future monitors. The device can operate for 24-hour periods, with near-continuous detection of the baby’s heart beat.This has never before been possible, and could lead to a new approach to the management of pregnancy, especially in high-risk cases. In addition, the monitor can provide reassurance if a mother notices something peculiar during her pregnancy, for instance that her baby doesn’t seem to be moving.The research team believes that the new device will initially impact babies who fall into high-risk groups, groups which make up about ten per cent of all babies born. In the UK that’s 70,000 babies a year. Dr Crowe says, “Opinion from mothers on the usability of the monitor has been positive.They seem reassured when they see evidence of their baby’s heart beat, and this can also help with mother-child bonding.” Amazingly, all this technology fits into a neat gadget the size and weight of a small mobile phone.The technique is non-invasive — sticky electrodes, which record the heart beat, are simply placed on top of the expectant mother’s tummy — and is more comfortable than previous methods of monitoring.The portable nature of the equipment means that mothers should be able to wear it at home and operate it themselves, without being bed-bound.
Many hands make monitors work
Developing this instrument required input from a number of specialists in the fields of biology and engineering, including Dr Hayes-Gill and Dr Crowe, as well as clinical expertise, provided by, among others, Dr Margaret Ramsay. Dr Ramsay’s experience has shown that mothers with high-risk pregnancies are generally keen to have fetal surveillance, but also value their freedom, particularly if they have other Mother-to-be Judith Challand being monitored by midwife Aileen Hourihane using an earlier 1999 prototype children. Use of an unobtrusive and portable monitor means that they can have both. Action Medical Research has played a vital role in the progress of the monitor over the years.The Charity funded three research projects spanning eight years, allowing both development of the prototype and its clinical trial in women with high-risk pregnancies. Now, after years of dedicated research and hundreds of heart rate recordings from mothers and their babies, this new technology is almost ready for homes and hospitals. Following a number of developments to the original prototype, patents for the technique have been filed, and a team of professionals is now working to bring the product to the public. Dr Carl Barratt, a co-founder of Monica Healthcare, the company that will produce the monitors, is grooming the device for its launch. An engineer with a focus on wearable medical devices, he says that the final product is undergoing various formal tests before it can be used by hospitals.The team hope to have it available in the UK and Europe soon, and are working towards a launch date of September this year.
Dedication to saving tiny lives
It is impressive to see what dedication, team work and a touch of inspiration can achieve.The long-term commitment and combined skill of a team of researchers in Nottingham, coupled with the backing of Action Medical Research and the Charity’s generous supporters, has fashioned an idea into reality. Action Medical Research is no newcomer to protecting pregnancy. Back in the 1970s the Charity helped develop the medical use of ultrasound scanning, which is now routine in care of the unborn child, and also discovered the link between taking folic acid during pregnancy and reducing the incidence of spina bifida.Through our Touching Tiny Lives Campaign this commitment to giving all babies a healthy start in life continues, and the development of this fetal heart monitor is an achievement that the Charity is particularly proud of.