Better monitoring of maternal health will save lives

High blood pressure, bleeding and infection account for more than 50% of maternal deaths worldwide. Most of these deaths are preventable. Early detection and effective management of these conditions relies on monitoring vital signs, including pulse and blood pressure. Once detected, life saving interventions can be administered. However, healthcare workers in low-income countries often lack the necessary equipment and training.

A new vital sign device has been shown to accurately predict the risks of pregnancy-related complications. The CRADLE Vital Signs Alert (VSA) is a hand-held, semi-automated device which detects hypertension and circulatory shock with an early warning system. It was developed by a UK-India research collaboration. The team won the 2017 Newton Prize for their work to introduce the device into 10 community and hospital maternity care sites in India, Ethiopia, Zimbabwe, Zambia, Uganda, Sierra Leone, Malawi and Haiti.

The vast majority (94%) of maternal deaths occur in low and lower middle-income countries (WHO, 2019). The CRADLE VSA is affordable, easy-to-use, and portable with low power requirements – perfect for use in low-resource settings.

More than 3300 devices have been delivered to hospitals and clinics, and successfully incorporated into routine care, sometimes as the first blood pressure device available in the clinic. More than 1500 healthcare workers have been trained to use the device. Results show that the VSA traffic light system will help save lives.

After winning the 2017 Newton Prize, the team were able to deliver over 1000 CRADLE devices to three Ugandan refugee settlements and trained a further 1000 healthcare workers.

The device has been shown to detect both pregnancy-related and other medical conditions. In Uganda, the device was shown to aid Malaria detection as well as hypertension screening. It has also been demonstrated as an effective as a screening tool for pregnancy anaemia, a condition that affects 80% of pregnant Indian women and can increase risk of poor maternal and neonatal outcomes.

When the COVID-19 pandemic hit, limited face-to-face antenatal care led to concerns poor maternal and neonatal outcomes would increase. The Newton Fund project showed the CRADLE VSA was well-received by women monitoring their own blood pressure in developing countries. Subsequently, a home blood pressure monitoring service has been established at St Thomas’ Hospital, UK.

According to the team, winning the Newton Prize enabled work that would not otherwise would not have been possible. The projects have strengthened existing research partnerships and led to new ones. Outputs have informed further funding applications to continue to refine this important intervention.

Find out more about the CRADLE research here: https://youtu.be/yjmCmr-jers

The project was delivered through the Medical Research Council (MRC) in the UK and the Department for Biotechnology in India.

Project title: Evaluation of the introduction of a novel device in the management of hypertension and shock in pregnancy in low-resource settings

Project leads: Professor Andrew Shennan, Kings College London’s Women’s Health Academic Centre at St Thomas’ Hospital in London and Professor Shivaprasad Goudar, Women’s and Children’s Health Research Unit at Jawaharlal Nehru Medical College in Belgaum

Delivery partners:  Medical Research Council, part of UK Research and Innovation, and India’s Department for Biotechnology

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