“Technology like art is a soaring exercise of the human imagination.” – Daniel Bell
The current climate in the practice of gynecology and obstetrics is much influenced by the COVID pandemic and the fact that access to health care is limited. Additionally, the stressful environment has made women vulnerable to be deprived of important preventive health care measures as well as be at risk of issues such as preterm births, preeclampsia (also called gestosis where blood pressure rises and is a severe pregnancy complication), foetal jeopardy and other complications. Technological advances are much into existence and through this write up I am going to discuss some such emerging advances which can help women’s health monitoring for a better outcome. Following are areas that are of prime importance for women’s health and the emerging technologies in context.
1. Prevention of preterm birth: As we know India has the topmost numbers of preterm deliveries globally increasing the burden on the health care system, challenging the health of the future generation, and causing huge financial and emotional stress. An interesting gadget designed by Pregnan Tech Company from Misgav, Israel which is a device that can be implanted over the cervix (opening of the womb) seems to have a promise. This device is called the LIONESS made up of silicon which is proposed to prevent the cascade of events that occur to cause the shortening and softening of the cervix and finally dilatation resulting in premature birth. This a nonsurgical, safe solution which is a silicon ring placed with a special carrier and keeps the cervix long and nonamenable till the patient is 9 months pregnant. The delay in the initiation of the biochemical cascade prevents collagen breakdown and thus preterm delivery. The device is tested for clinical safety usage in women undergoing hysterectomy and will be eventually tested in pregnant mothers to be used in clinical practice.
2. Home-Tele ultrasound a personal device to assess foetal well-being: With a lack of access to care and to prevent exposure to the covid infection this home-based device seems to offer a solution and is being created by PulseNmore, a firm from Israel. The device has an ultrasound transducer at the bottom and is a dock for a smartphone that can capture high-quality images that can be shared with the patients’ health care provider for interpretation and guidance. This certainly has a promise of providing optimal health care not only during the pandemic but beyond as conditions such as rupture of membranes, foetal jeopardy, amount of amniotic fluid, etc can be detected and immediate, apt action be taken. The makers consider this to be affordable and accessible and truly seems to be a major leap forwards in the digital system as it can be used with minimal training by the pregnant woman and her family.
3. Cordless electronic foetal monitors. Electronic foetal monitors used during labor have helped in closely monitoring the foetal condition during delivery and also providing documentary evidence of the entire duration if so desired. This has also helped in bringing about safety during delivery and an opportunity for early detection and timely intervention to deliver babies safely. The challenge however has been that the woman is bedbound and strapped to the machine and cannot ambulate during labor. Ambulation during labor has been proved to be beneficial as it provides good oxygenation and helps the mother to be in a comfortable position thus aiding improved delivery outcomes. Newer gadgets have now become available which offer remote monitoring during delivery with benefits such as comfort, mobility, and flexibility. Some transducers are attached to the mother’s womb and are remotely connected to the machine and these keep on recording the foetal condition as well as the uterine contractions. Also, the record can be sent on a smartphone to the consultant as in the diagram below:
Diagram 1: Screenshot of the report received by me on my smartphone depicting the foetal heart rate, presence of good accelerations, and foetal movements depicting good foetal condition.
4. Glucose monitoring sensor: Diabetes is on the rise and more so in pregnancy. During pregnancy, nearly 15-20 percent of mothers are affected with gestational diabetes which can cause maternal and foetal health complications. These can be avoided by stringent sugar levels and these need to be monitored regularly. Below is a record received from a patient with gestational diabetes who had a glucose sensor fitted which recorded her sugar levels. As we understand for optimal outcomes, we need to have stringent glucose levels, and this can be achieved by using the sensor which tracks the glucose levels helping the patient as well as the clinician. The picture below depicts the record received from a patient being treated for gestational diabetes.
5. Home-self blood pressure monitoring: Preeclampsia -Gestosis is common and a dangerous complication of pregnancy and the single pointer of diagnosing this condition is the blood pressure measurement in a clinical setting. Thus, the woman when visits the facility then only the blood pressure is checked. Checking blood pressure at home can help early detection and proper management of hypertension in pregnancy. Women at risk or universally can be encouraged to do self-blood pressure measurement with the use of a smartphone, accelerometer, and a conventional blood pressure cuff. This has been created by workers in Purdue and is called the pressor testing system that allows consistent, reproducible evaluations of blood pressure. The woman can be guided to report to the facility in case of abnormal readings and the occurrence of other signs of gestosis. This has been studied in 25 pregnant mothers and the data is published and is soon expected to be available for commercial use.
The technological advances and their implementation in medical practice are truly enthralling and the progress must go on.
“Let’s go invent tomorrow instead of worrying about what happened yesterday.” – Steve Jobs
About the Author – Dr. Girija Wagh, Gynecologist
Dr. Girija Wagh is an expert Gynecologist with 27 years of experience in clinical practice and teaching gynecology. As a renowned academician, she has many research papers published. She always keeps herself updated with the current knowledge and latest trends. Dr. Girija through her position in FOGSI has advocated for women’s health issues to the government. She has been a member of the CSB PCPNDT Act and national mentor under the LaQshiya initiative. She also specializes in complicated pregnancy conditions and infertility. Not limiting to just this, Dr. Girija is a compassionate doctor and counsellor.
