Three years ago, Monash University clinical research fellow Dr Vinayak Smith approached the head of the Department of Obstetrics and Gynaecology, Professor Euan Wallace, with an idea. Now that idea has developed into a device being trialled in hospitals globally – and looks set to improve health prospects for pregnant women and their unborn babies.
The innovation is a wearable monitor for pregnant women. It measures, in great detail, the heart rate of the mother and her foetus, sends the information to an app on a mobile phone, and then to a central portal where the data is checked by expert midwives and medical staff.
The product in trials is called the FeMom. It's made by a Singaporean company, Biorithm – and is a virtual maternity clinic, meaning the pregnant woman no longer needs to leave home to be monitored. The small device would be prescribed by the patient’s obstetrician; it attaches to the stomach.
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“We have never been able to do this from a surface monitor,” says Dr Smith. “It will give us a lot more insight into what is going on physiologically. We can see much more in terms of heart rate intervals – it's very hardcore science on the foetal heart rate. As we learn more and more, we'll build on it in the future.
“This enables us to move care to an outpatient setting, in the woman’s home. It's empowering women to let them go from the hospital with this. They don’t need to come to the hospital and be inconvenienced. We want to get into a regime that proves we can do this in a very methodical way at home.”
Foetal heart rate monitoring is currently done in hospitals – with the women as inpatients – via cardiotocography (CTG) technology. Women commonly have to go to hospital two or three times a week, and sometimes travel long distances.
Professor Wallace says handing control to women is a key driver of the project.
“It's very disruptive and cumbersome for women to come into the hospital up to two or three times a week,” he says.
“CTG remains the bread-and-butter approach to foetal surveillance to know if a baby is unwell, but for women living in the country, for example, it’s a huge thing. They have to travel bigger distances, and they have fewer staff on site to do the interpretations and management. They're waiting longer.
“Essentially, this is about moving control into the hands of the woman so she can do the monitoring at home. It can then be interpreted at the hospital or a central point in real time. It allows a much timelier intervention if that is what's needed, enabling us to deliver babies in better condition. It certainly has the promise of better outcomes.
“This,” he says, “is healthcare slowly dragging itself into the 21st century.”
Foetal monitoring through CTG has remained largely unchanged since its invention in the 1960s. The FeMom device can not only monitor heart rates in a more detailed way, but it can provide clearer distinctions between the mother and baby’s heartbeats, allowing faster and clearer identification of babies that aren't doing well in utero. A Monash survey, conducted during pilot trials, showed 80 per cent of mothers would prefer to use the device than standard CTG.
“There's been a fearfulness around trusting patients to make the best decisions for their own healthcare,” says Professor Wallace. “But we know that mothers everywhere want the best for their babies, so why not give them what they need to do that? This is genuine patient-centred care.”