Description of Session
• Newborn deaths remain unacceptably high in low-income countries despite increased emphasis on newborn resuscitation. Fetal outcomes can be significantly improved by the use of fetal monitoring during labor and delivery, however this requires sophisticated analysis of fetal heart activity patterns. This is done routinely in high income countries, but is often too expensive for use in low-income countries. Through funding from a Saving Lives at Birth award, D-tree International developed a very low-cost device (approximately $100 compared to the traditional $2000 - $5000) that accurately monitors fetal heart activity, and is connected to a mobile solution which provides decision support to midwives based on WHO algorithms. • The tool captures and displays data on uterine contractions and fetal heart activity patterns. The analysis of fetal heart activity, including accelerations and decelerations, is consistent with globally recommended criteria for fetal distress. From February to April 2019, 28 midwives were trained and used this tool at Queen Elizabeth Central Hospital labor ward in Malawi to monitor the fetal condition for 101 women who were in labor. The device was perceived by midwives to be easy to use and provided more timely decision making. Additionally, women were satisfied with the device as it did not cause pain and allowed visualization of the fetal heart rate. • In this presentation, D-tree will share the experience of developing a low-cost fetal monitoring device and its use by midwives in monitoring women during labor in Malawi. This device has the potential to improve newborn outcomes more globally, by improving the accessibility and quality of care provided during labor and delivery. The low cost and ease of use makes it possible for use in health centers and district hospitals where deliveries are done throughout Malawi and other less developed countries.
