Smartphone apps and wearables improve pregnancy care in low-resource communities

Published in

Purdue Engineering Review

4 min readOct 2, 2020

Smartphones and wearable devices that send and receive data will revolutionize health care in the coming decades. This is particularly true in developing countries that are skipping traditional landlines in favor of cell phones. It is amazing to see that in many poorer nations, a large percentage of the population has smartphone access. By focusing on low-cost, ambulatory health care technology that aids in remote monitoring, we can target low-income countries and rural portions of developed nations where health care availability still is an issue.

Take, for example, the challenge of preeclampsia. This is pregnancy-induced high blood pressure that progresses to a range of additional problems, including headaches or seizures, kidney injury, and bleeding. It is a huge issue because high blood pressure affects 25 percent of pregnancies — every year, 50,000 women die from preeclampsia, and 300,000 children are born prematurely, with all the complications that ensue from early birth.

Historically, there has been no good way to predict if a patient will develop preeclampsia, and once it has developed, it can be too late to reverse the condition. Supported by funders including the Bill & Melinda Gates Foundation, we created a solution based on the medical insight that poor blood flow through the kidneys plays a significant role in causing the disorder. When a woman lies on her back, blood can get into the kidneys, but it cannot get out, causing high blood pressure. Women with fewer veins that return blood to the heart have a vulnerable anatomy, making them more likely to develop high blood pressure.

We use a smartphone app and a wearable — a blood pressure cuff — to measure and compare a woman’s blood pressure on her side versus on her back. An acute rise in blood pressure when the woman shifts her position predicts susceptibility to preeclampsia later in pregnancy. The technology we are developing for clinicians and expectant mothers compares a woman’s resting position and blood pressure in these positions to automatically detect who is at risk.

Purdue University researchers are developing an app and wearable technology that will allow pregnant women to use a smartphone to detect whether they have or are susceptible to a preeclampsia, a complication caused by high blood pressure that can cause organ damage and premature birth. The device uses the supine pressor test, which measures whether a woman’s blood pressure increases when she changes position from lying on her left side to lying on her back. If the diastolic pressure increases enough, it is a warning sign that a woman is susceptible to preeclampsia.

The benefit of our technology is that a clinician can send a patient home with an automated preeclampsia detector to be used during the risky part of her pregnancy (i.e., 20 to 35 weeks). If the test suggests she is vulnerable, we can customize and monitor her resting position, with the goal of preventing the condition from developing.

We have begun an outreach program with global health groups that provide care to pregnant women around the world. For example, a group of pediatricians from Seattle has a decades-long relationship with a hospital in Liberia, and the Academic Model Providing Access to Healthcare (AMPATH) program is performing work in Kenya. Our hope is that these efforts can improve prenatal education so women are taught “SOS” — Sleep on Side — during pregnancy.

In addition, we see other potential applications for the technology. People with obesity-related high blood pressure appear to have a similar high blood pressure mechanism — because any mass in the abdomen, whether from a baby or obesity, affects kidney blood flow when patients are supine. So, the device that helps a pregnant woman manage her resting position also could be used to enhance prediction and prevention of hypertension in an obese individual. Our device can monitor sleep position and ping patients, facilitating therapeutic positioning, a solution that also may help people at risk of obstructive sleep apnea and dementia.

A pregnant woman wants to know about her health status, and she is extremely motivated to do anything possible to increase the well-being of her unborn child. Our goal is to make this easier without expensive clinic visits that can require traveling long distances. Our vision is to then extend the technology to help an expanded group of patients predict, manage, and ideally prevent pathology. When we can forecast and avert disease, patient outcomes improve, quality of life increases, and health care costs go down.