Indigenous women in remote and rural Australia experience premature births, fetal deaths and other complications at more than twice the rate of other Australian women. Researchers at Edith Cowan University in Perth are hoping to change that by providing affordable, portable fetal monitors that expectant mothers can use to check for signs of fetal distress and relay vital information to healthcare professionals.
Insufficient Prenatal Care for Rural Populations
Over the last decade, the rate of premature births and fetal deaths among the Indigenous population of rural and remote Australia was more than twice that of the non-Indigenous population. Because of the distance that women in these isolated communities often must travel to reach health centers and hospitals, many do not get the proper medical care to prevent or address prenatal issues.
As Dr. Alfred Tan, a senior lecturer at Edith Cowan University, says, “The tyranny of distance and its associated costs remain a barrier for delivering reasonable quality [prenatal] care to remote and rural populations.”
Tan cites the example of a woman who lost the twins she was carrying because she lived too far from a medical facility to get regular checkups. By the time doctors discovered a problem with her pregnancy, it was too late to save the babies.
An expert in mobile and wireless technologies, Tan and his colleague Dr. Martin Masek, a researcher in biomedical engineering, aim to improve the quality of prenatal care in rural and remote communities by providing expectant mothers with an inexpensive, portable, Doppler-based ultrasound device connected to a smartphone running Windows Mobile.
Software to Track, Transmit, and Process Medical Information
With financial, software, and hardware support from Microsoft External Research, Tan and Masek are developing software that can be downloaded at no cost to any Windows Mobile smartphone. When connected to a low-cost fetal monitor, the smartphone will enable expectant mothers to track and keep a record of the fetal heart rate and activity in the womb and transmit that data to obstetricians or midwives at urban or regional health centers. The system also can be used to track and relay critical information during premature births.
Tan’s team has been developing the system since early 2008, using Microsoft Visual Studio 2008 software development tools and the Microsoft SQL Server 2008 data platform. Microsoft has also provided the smartphones used in the research.
Fetal monitors connected to Windows Mobile–based smartphones are being developed by Drs. Martin Masek and Alfred Tan (far left and far right), researchers at Edith Cowan University. They are working with research assistant Chang-Su Lee and Angela Fyneman, manager of the Family Birth Unit at Mercy Hospital Mount Lawley in Western Australia.
One important aspect of the smartphone software, in addition to transmitting data to a hospital or medical center, is the ability to process the information and provide important details to an expectant mother and her physician or midwife.
For example, the system can track a baby’s kicks inside the womb. With healthy babies, increased activity is typically associated with an accelerated heart rate. Kicking without any heart rate acceleration is a sign of distress—and a reason to see a doctor right away.
For mothers who go into early labor, the monitor can relay vital information to medical professionals while the patient is making her way to the hospital. This will represent a significant improvement over having the mother—or a friend or family member—try to describe what is happening to a care provider over the phone.
Tan and Masek’s system fills an important gap in the available technology, particularly for rural and remote use. On one end of the spectrum are inexpensive handheld monitors that can pick up a baby’s heartbeats but cannot process the information or transmit it in real time. On the other end is high-end portable monitoring equipment that is designed to transmit information to doctors remotely but costs hundreds of thousands of dollars.
The combination of the software and the smartphone is the key to the project, says Tan. “It allows you to expand the care to remote and rural areas, whether it’s Australia or anywhere. It’s known that if you can provide earlier care, you can halve the mortality rate.”
Smartphone-based Solution Could Reduce Time in Hospital
Interestingly, the technology also has the potential to reduce the amount of time that pregnant women from rural and remote communities spend in the hospital. That is because Indigenous women with higher-risk pregnancies are often admitted to hospitals for monitoring because they live too far away to get regular checkups or cannot get to the hospital quickly in an emergency.
“By allowing [prenatal] care to be provided from home, our solution will reduce and relieve the stress currently put on the health system,” says Tan. “This will further free up the health system—and hospital beds—to serve those who are in greater need.”
Project Status and Future Applications
First, Tan and his colleagues must complete their work. The researchers have used information gathered from patients at Mercy Hospital Mount Lawley in Western Australia to test the system’s accuracy against the hospital’s electrocardiogram. Among other things, they have investigated the length of time required for readings to produce an accurate measure.
Further tests with the hospital’s patients will check the system’s reliability, its compatibility with existing hospital equipment and its ability to keep patient data private and secure. Tan and Masek are working with Mercy to design a field test in which Indigenous Australian women will be trained to use the equipment and then observed to determine the system’s ease of use, accuracy, and security.
Results of the project will be published in technical journals and shared at conferences, and the software will be freely available on the Internet. Tan has talked to medical device companies to gauge their interest in the system and says they are excited about its potential.
Researchers also see broader potential uses for the software, such as for monitoring the heart conditions of elderly cardiac patients who have difficulty leaving their homes.
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An External Research-funded project supporting advanced technology research |
Project Principals
Alfred Tan, Ph.D., senior lecturer, School of Computer and Information Science, Edith Cowan University
Martin Masek, Ph.D., senior lecturer, School of Computer and Information Science, Edith Cowan University
