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  • Professor Arik Eisenkraft, MD, MHA, Ozzie Paez

Innovating preeclampsia care

Updated: Dec 1, 2022

I previously shared a CDC study and supporting data that highlighted the role of blood pressure in maternal morbidity and worsening trends in severe maternal complications. This post focuses on a related dangerous pregnancy condition, Preeclampsia, and how new cuffless cardiovascular sensors are innovating the diagnostic process and opening at-home monitoring opportunities. I asked Professor Arik Eisenkraft, MD, MHA, Biobeat’s VP Clinical and Regulations, for his medical insights and he graciously agreed to co-author this post.


PREECLAMPSIA


Preeclampsia is a serious condition that develops usually after the 20th week of pregnancy in women whose blood pressure had previously been within the normal range. It is characterized by high blood pressure (above 140/90 mmHg) and high levels of protein in the urine (proteinuria). The condition can threaten the health and lives of the mother and baby when left untreated by putting stress on the heart, liver, and kidneys, affecting blood flow to the placenta, and causing fluid buildup in the lungs[1], [2]. Preeclampsia is responsible for approximately 15% of premature births in the US each year. While it is most common during pregnancy, it can also manifest after delivery (postpartum preeclampsia) and threaten the health of the mother.

Expecting mothers are routinely monitored for preeclampsia, which in many cases remains untreatable and is generally resolved by childbirth. When detected late in the pregnancy (after 37 weeks), the baby is usually delivered without delay. When it develops earlier, mothers are often hospitalized for close monitoring and given drugs to promote the fetus’ lung development. In-hospital monitoring relies on legacy cuff-based blood pressure instruments that compress the upper arm and brachial artery each time the patient’s blood pressure is taken. This method, which is limited to measuring blood pressure and heart rate, becomes uncomfortable and painful after days and sometimes weeks of hospitalization[3].

There are innovative new alternatives for evaluating expecting mothers’ blood pressure, helping with the diagnosis of preeclampsia and monitoring those affected. Specifically, Biobeat’s cuffless ABPM, multiday sensors, and wrist-worn long-term monitors have transformed how blood pressure and other cardiovascular vitals are captured, baselined, monitored, and analyzed. ABPM is ideal for monitoring expecting mothers at specific points during their pregnancy. The comprehensive blood pressure profiles, based on gold-standard 24-hour Ambulatory Blood Pressure Monitoring Protocols[4], trend blood pressure, heart rate, mean arterial pressure, and other hemodynamic parameters.

In cases where preeclampsia is diagnosed, continuous monitoring is easily implemented via multiday cuffless sensors and long-term wrist-worn monitors that capture and display in real-time a full panel of cardiovascular and related vitals on connected stations and devices, blood pressure, respiratory rate, SPO2, and heart rate. Monitoring frequency can be set from continuous to once every fifteen minutes based on doctor recommendations.

The advanced remote patient monitoring made possible by these innovative technologies supports at-home monitoring that can save weeks of in-hospital stays. Expecting mothers remain at home and avoid the discomfort of repetitive arm compressions, hospitals save beds while actively monitoring more patients, clinicians gain access to real-time, robust vitals panels and monitoring history, and insurers save tens of thousands in covered hospital costs. New mothers can be similarly and comprehensively monitored post-partum through continuous active monitoring and ABPM for as long as clinically necessary.


Implications


These impressive advances in performance fueled by technological innovations have been the norm across industries since broad connectivity and the Internet became a reality twenty-five years ago. Medicine has been more cautious than other industries in innovating its services due in part to regulations and ingrained conservative cultures. Costs are a major factor because many innovative medical technologies require large capital investments and extensive personnel training. By contrast, innovative sensor technologies, artificial intelligence, and advanced analytics are delivering affordable, financially sustainable compelling value to healthcare stakeholders including patients, doctors, providers, and insurers.


Measured in traditional business metrics, innovative technologies like Biobeat’s cuffless cardiovascular monitoring lower costs, improve capacity, and deliver quick returns on investments. Best of all, in this instance, they also deliver compelling value to mothers and their babies by reducing risks throughout their pregnancy and postpartum.


References


Figure 1 Reference:

U.S.-Born Black Women at Higher Risk of Preeclampsia than Foreign-Born Counterparts.


Text References:

[1] Preeclampsia, Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/preeclampsia/symptoms-causes/syc-20355745, accessed October 26, 2020. [2] Preeclampsia, Cleveland Clinic, https://my.clevelandclinic.org/health/diseases/17952-preeclampsia, accessed October 27, 2022. [3] Ozzie Paez, Hypertension and Pregnancy, October 19, 2022, OPRHealth, Hypertension and pregnancy (oprhealth.com). [4] Paolo Palatini, Ambulatory and Home Blood Pressure Measurements, AHA Journals, November 14, 2011, https://www.ahajournals.org/doi/full/10.1161/HYPERTENSIONAHA.111.184184

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