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在高资源和低资源卫生环境中,利用无线网络、柔软灵活的传感器对妊娠进行全面监测。

Comprehensive pregnancy monitoring with a network of wireless, soft, and flexible sensors in high- and low-resource health settings.

机构信息

Sibel Inc., Niles, IL 60714.

Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599.

出版信息

Proc Natl Acad Sci U S A. 2021 May 18;118(20). doi: 10.1073/pnas.2100466118.

Abstract

Vital signs monitoring is a fundamental component of ensuring the health and safety of women and newborns during pregnancy, labor, and childbirth. This monitoring is often the first step in early detection of pregnancy abnormalities, providing an opportunity for prompt, effective intervention to prevent maternal and neonatal morbidity and mortality. Contemporary pregnancy monitoring systems require numerous devices wired to large base units; at least five separate devices with distinct user interfaces are commonly used to detect uterine contractility, maternal blood oxygenation, temperature, heart rate, blood pressure, and fetal heart rate. Current monitoring technologies are expensive and complex with implementation challenges in low-resource settings where maternal morbidity and mortality is the greatest. We present an integrated monitoring platform leveraging advanced flexible electronics, wireless connectivity, and compatibility with a wide range of low-cost mobile devices. Three flexible, soft, and low-profile sensors offer comprehensive vital signs monitoring for both women and fetuses with time-synchronized operation, including advanced parameters such as continuous cuffless blood pressure, electrohysterography-derived uterine monitoring, and automated body position classification. Successful field trials of pregnant women between 25 and 41 wk of gestation in both high-resource settings ( = 91) and low-resource settings ( = 485) demonstrate the system's performance, usability, and safety.

摘要

生命体征监测是保障孕妇、产妇和新生儿健康与安全的基本环节。通过该监测,可以尽早发现妊娠异常,为母婴提供及时、有效的治疗,从而降低母婴发病率和死亡率。现有的妊娠监测系统需要将大量设备与大型主机相连接,通常需要使用至少五台具有不同用户界面的独立设备,分别监测子宫收缩、母体血氧饱和度、体温、心率、血压和胎儿心率。现有的监测技术昂贵且复杂,在资源匮乏地区的实施存在诸多挑战,而这些地区的母婴发病率和死亡率最高。本研究提出了一种集成监测平台,该平台利用先进的柔性电子技术、无线连接技术以及与各种低成本移动设备的兼容性,为孕妇和胎儿提供全面的生命体征监测。该监测平台使用三个灵活、柔软、低轮廓的传感器,实现了时间同步操作,可提供连续无袖带血压、基于电刺激的子宫监测以及自动体位分类等先进参数,从而对孕妇和胎儿进行全面的生命体征监测。该系统已在高资源环境(n = 91)和低资源环境(n = 485)中对妊娠 25 至 41 周的孕妇进行了现场试验,结果表明该系统具有良好的性能、可用性和安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2f6/8157941/eb18b7ea1358/pnas.2100466118fig01.jpg

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