More innovation, less hospital?

Today, I will shed some light on innovations in the hospital setting that have the potential to serve the wellbeing of mothers and children during different stages of pregnancy and childbirth. For instance, the Belli makes it possible to monitor the last stage of pregnancy at home, while the LifeStart trolley allows direct first care to your baby in combination with delayed cord clamping and the Baby Vision monitor allows a mother to keep an eye on her baby when admitted to the neonatal high intensive care unit.


Prenatal - Belli

The Mobile Health Unit of the East Limburg Hospital in the Belgian city of Genk is currently the only European hospital testing and trying to validate Belli for clinical use. Belli is a small mobile electrohysterogram device that measures the electrical activity of your uterus. It is attached to a pregnant woman’s belly and sends data to a mobile app via bluetooth. The device is able to count and classify contractions and provides real time information to the mother about what is happening. In the present research, the device enables midwives and gynaecologists to continuously monitor pregnant women at home. Furthermore, the researchers are trying to find out whether a combination of the data and lifestyle parameters might be used in predicting preterm labor. The follow up of high risk pregnancies in the comfort of women’s homes would mean a saving in hospitalisation costs and would add to everybody’s convenience. In the meanwhile, Belli has already made its way to the consumer market in the US to allow self-monitoring. Even though enthusiasm about the possible clinical use of Belli is appropriate, I think one should have strong reservations about its commercialisation and application to normal low risk pregnancies. However, if you would like to read a user review, you can try one here.

Intrapartal - LifeStart trolley

The Liverpool Women’s Hospital announced that it will be extending its delayed cord clamping practice and bedside neonatal care to all newborns, including those requiring resuscitating. Previously, the cords of the latter had to be clamped immediately for the baby’s to be brought to the resuscitating unit. With its warming system, suction equipment, gas flow metre, gas blender and t-piece resuscitator the LifeStart trolley now allows for this care to be delivered right at the bedside.


An initial study into the usability and safety of the trolley showed that the greater part of the 78 baby’s included could receive the treatment at the bedside and without having the cord clamped immediately. Another interview based study, which has its methodological limits, indicated that most parents were positive about the trolley and about the bedside care, although some reported stress about witnessing the resuscitation of their newborn child.


The LifeStart trolley is an English finding that was introduced in 2012 and has since been studied and developed further. The Liverpool Women’s Hospital is the first hospital in the United Kingdom to introduce the trolley.

Postnatal - Baby Vision monitor

​​Another innovation in the hospital is as simple as it is ingenious. If mothers, for whatever reason, can’t be with their newborns who are admitted to the neonatal intensive care, why not provide them with a good view of their child? Over the last years, more and more hospitals across the world have been putting modern technology such as iPads and FaceTime to good use in this respect.


One recent example is the maternity ward of Bath hospital in England, which recently announced the introduction of ‘Baby Vision monitors’ (or ‘Baby Monitoring carts’, as the manufacturer calls them) on their Facebook-page. While one cart holding a tablet is positioned near the baby, another one is close to the mother, who can now see and hear her child. The hospital writes that although it might not be the same as actually holding your child, “it means that Mums don't have to feel like they're missing out in those first few precious days”.


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Resources

De Mobile Health Unit test nieuwe, revolutionaire zwangerschapsapp, Zolarium 2016, 60:14-15. See:

http://www.zol.be/sites/default/files/publicaties/zolarium/artikel/pdf/zolarium-60-gynaecologie_mobile_health_unit.pdf

Mobile Health Unit, East Limburg Hospital, Genk

http://mobilehealthunit.org/projects/prenatal-health-technologies/

The 2014 study into its usefulness:

Thomas, M.R., Yoxall, C.W., Weeks, A.D. & Duley, L. (2014) Providing newborn resuscitation at the mother’s bedside: assessing the safety, usability and acceptability of a mobile trolley BMC Pediatr. 14: 135. doi: 10.1186/1471-2431-14-135, see: http://bmcpediatr.biomedcentral.com/articles/10.1186/1471-2431-14-135

The 2015 study on the parents’ views:

Sawyer, A., Ayers, S., Bertullies, s., Thomas, M., Weeks, A.D. et al. (2015) Providing immediate neonatal care and resuscitation at birth beside the mother: parents’ views, a qualitative study. BMJ Open; 5(9). Doi: 10.1136/bmjopen-2015-008495, see: http://bmjopen.bmj.com/content/5/9/e008495.full

More on the history and development of the LifeStart trolley:

Weeks, A.D., Watt, P., Yoxall, C.W., Gallagher, A., Burleigh, et al. (2015). Innovation in immediate neonatal care: development of the Bedside Assessment, Stabilisation and Initial Cardiorespiratory Support (BASICS) trolley. BMJ Innov (1), 53-58. doi:10.1136/bmjinnov-2014-000017, see: http://innovations.bmj.com/content/1/2/53.full

The Bath hospital maternity ward:

http://www.ruh.nhs.uk/patients/services/maternity/index.asp?menu_id=1

The Baby Monitoring cart:

http://www.paritymedical.com/mobile-computer-carts/baby-monitoring-cart

Photo credits

Belli: Website Bloomlife.com

Baby Vision Monitor: Bath Maternity Facebook

LifeStart Trolley: Website inditherm.co.uk

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