During childbirth, the baby’s heart rate, the mother’s heart rate and uterine activity are continuously monitored. This information helps healthcare professionals assess the baby’s condition and keep track of the progress of labor. However, the technology that has been used for this purpose for many years can suffer from signal loss at crucial moments, for example when the mother or baby moves.

An electrode can be placed to improve the signal. However, this invasive method carries risks for both mother and baby, such as infections, and is therefore not preferred.

TU/e PhD candidate Ivar de Vries also worked with the technology as part of this project. While he focused on developing algorithms to detect complications during pregnancy at an earlier stage, Berben is primarily investigating the clinical applicability of the technology during and after childbirth.

More accurate measurements

The new method can accurately measure the heart rates of both baby and mother, as well as uterine activity, during childbirth. This allows healthcare professionals to better assess the baby’s condition. The baby’s heart rate is considered in relation to uterine contractions.

If there is too little uterine activity, for example, healthcare professionals can administer medication to stimulate contractions at an earlier stage. This can prevent prolonged labor and reduce the risk of infections and postpartum blood loss.

However, too many contractions can also pose risks. “With every contraction, the baby temporarily experiences a small degree of oxygen deprivation. Normally, babies can cope with this quite well because they have various compensatory mechanisms,” Berben explains. “But if you have too many contractions, the baby may not recover as well, and that can become dangerous.”

More accurate measurements could help healthcare professionals intervene earlier when necessary—while also preventing unnecessary interventions.

Greater freedom of movement

The new method is not yet being used during childbirth in the Netherlands. To test the method in practice, Berben set up a large clinical study, which is still ongoing. The results will show whether the central hypothesis is correct: that more accurate measurements ultimately lead to fewer interventions, such as Caesarean sections and assisted deliveries, in which an instrument is used to help deliver the baby.

Patient satisfaction is also an important factor. Because the monitoring is completely wireless, women have greater freedom of movement—something they often consider important. “With the old monitoring technology, it is important not to move too much during the measurement in order to obtain accurate results. But try lying still when you’re giving birth,” says Berben.

Also after childbirth

In her PhD research, Berben is also studying the period immediately after childbirth. “There is still very little known about this, because current measurement methods are not suitable for accurately measuring uterine activity after childbirth. With the new method, we hope to gain more insight into this,” she says.

One of the greatest risks for women after childbirth is severe blood loss. Particularly in developing countries, this is a major cause of maternal mortality. One possible cause is that the uterine muscle is exhausted after childbirth and therefore does not contract properly. As a result, the blood vessels around the placenta are not compressed sufficiently, leading to heavy blood loss. A retained placenta can also cause blood loss.

However, we still do not have a good understanding of what uterine activity looks like during a normal course of recovery. “Essentially, you want to gain insight into normal physiology so that, in the future, you can recognize abnormal activity and prevent complications,” says Berben.

For now, this remains a hypothesis. The large study Berben set up, involving more than two thousand women, should provide greater insight into this.

From research to practice

During her PhD, Berben worked full-time in the hospital and experienced how much is involved in setting up a large-scale study. “It requires a great deal: all kinds of ethical approvals, because you are using a new device on pregnant women in an acute-care setting and collecting their data. That makes everything quite complex,” she says.

Moreover, many different parties are involved. A new method should not remain something developed by researchers; ultimately, the staff on the hospital floor have to work with it and, for example, be able to connect the device. That is why good implementation is at least as important as the technology itself, Berben believes. “Involve everyone at a very early stage,” is her advice.

The women who participated in the studies were also fully informed beforehand and could decide for themselves whether they wanted to take part. After giving their consent, the new device was connected as soon as labor began and used throughout the entire delivery, until one and a half hours afterwards. “It was always possible to switch back to the old method in the meantime if there were any concerns,” says Berben.

During the studies, Berben was regularly present on the ward to support patients and healthcare professionals, answer questions and help resolve any problems.

Although Berben cannot yet draw firm conclusions – her study is being continued by successors—she sees considerable potential in the new approach to monitoring. “Not only during childbirth, but especially in the period afterwards. I think the method has the potential to provide accurate results while also increasing patient satisfaction,” she concludes.

This article was translated using AI-assisted tools and reviewed by an editor