Introduction
Pregnancy and birth are among the most dangerous days in your life. Stillbirth tragically ends 3 million pregnancies globally every year whilst fetal asphyxia inflicted by labour is a leading cause of neonatal seizures, cerebral palsy and death. Pregnancy can also be detrimental to the mother and multisystem organ injury can result from preeclampsia, with delivery, often at preterm gestations, being the only treatment.
Unfortunately, current measures of fetal wellbeing during pregnancy and direct measures of fetal distress during labour are intermittent and often miss the critical point when a life-saving birth could be performed. Excitingly we are developing two devices to continuously measure markers of fetal distress in pregnancy and directly measure markers of fetal distress during labour. Furthermore, we have identified a possible medical treatment for preeclampsia, metformin.
Methods
With a team of electronic, material and chemical engineers and physicists we are using novel flexible electronics and artificial intelligence to develop a device to detect markers of fetal well-being non-invasively in pregnancy. Utilising cutting edge fibre optic and sensor technology we are developing a device to accurately measure direct markers of fetal distress during labour. We identified metformin as a possible treatment for preeclampsia in laboratory assays and have performed a randomised control trial evaluating its potential as a treatment for preterm preeclampsia.
Results
We recruited 150 pregnant women and discovered that 6 sensors positioned around the maternal umbilicus obtain a reliable fetal ECG. On implementing artificial intelligence, we were able to reliably extract the fetal ECG 97% of the time compared to traditional algorithms at 90% (p<0.05). We have developed a wearable sensor and wireless, portable hardware that is smaller and lighter than a smart phone that could be worn in pregnancy to continuously determine fetal well-being.
We have optimized the physics and chemistry of our sensor that could be used in labour and demonstrated it accurately detects a marker of fetal distress in buffers. We have promising data showing it accurately detects markers of fetal distress in biological samples.
We have shown metformin reduces antiangiogenic markers of preeclampsia in laboratory assays. We have performed a randomized clinical trial enrolling 180 women with preterm preeclampsia and excitingly demonstrated metformin prolonged pregnancy by 7 days (p = 0.056).
Conclusion
We are developing technology to continuously assess fetal well-being in pregnancy and labour and have discovered a possible treatment for preeclampsia. These devices and treatment have the potential to detect fetal distress and subsequently reduce stillbirth and hypoxic complications of labour and preeclampsia.