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App Automates, Simplifies Test for Preeclampsia

Pregnant woman

(Sergio Santos, nursingschoolsnearme.com, Flickr)

21 Oct. 2019. Results of a pilot test show a smartphone app makes a common test for the pregnancy complication preeclampsia simple and more reliable than before. A description of the app and pilot test findings appear earlier this month in the Journal of Engineering and Science in Medical Diagnostics and Therapy (paid subscription required).

A team from the Cardiovascular Imaging Research lab of biomedical engineering professor Craig Goergen at Purdue University in West Lafayette, Indiana aims to improve a common test for preeclampsia, a life-threatening condition resulting from a sudden rise in blood pressure in a pregnant woman. The condition affects blood flow to the placenta, and can result in excess protein in the urine.

Severe cases of preeclampsia can result in breakdowns in red blood cells, impaired liver and kidney function, and fluid in the lungs. The earlier in the pregnancy preeclampsia occurs, the riskier to outcomes for both mother and baby. The Preeclampsia Foundation says the condition occurs in 5 to 8 percent of all pregnancies.

A common test for preeclampsia, called the supine pressor test, measures a pregnant woman’s blood pressure with the woman’s body in two different positions: lying on her left side, then lying on her back. Changes in blood pressure readings from one position to another are an indicator of the disorder.

While the supine pressor test is easy to perform, its procedures were not standardized and results were unreliable, and has since been largely abandoned. Since its use began in the 1970s, reviews of the test found false positive rates as high as 46 percent. “When this test was used in clinics,” says Goergen in a university statement, “everybody was doing it slightly differently. What does ‘left side’ mean? How long does it take? It was not working well and was basically neglected.”

Researchers led by Indiana University medical student and first author Hamna Qureshi, a former biomedical engineering student in Goergen’s lab, prepared a smartphone app that provides common instructions for taking the supine pressor test. In addition, the app connects to a blood pressure cuff, to automatically record the woman’s blood pressure. The app then calculates the changes in blood pressure from lying on the left side to back, and calculates the user’s preeclampsia risk.

The researchers designed the app for use at home, without professional monitoring. Tests by the team with 25 women 20 weeks pregnant and non-pregnant women, show the app is easy to use, with results indicating the app’s feasibility. The findings also calculated common baseline measures showing an increase in diastolic blood pressure — the “top number” in blood pressure readings — as non-pregnant women shifted from left-side to back reclining positions. The baseline readings help interpret results when used by pregnant women.

The Bill and Melinda Gates Foundation funded the Purdue project in one of its global grand challenges programs, for use in remote and low-resource regions. “This device has a lot of potential to help pregnant women in many different settings,” notes Qureshi, “particularly rural and underdeveloped ones.”

The university filed a provisional patent — essentially an intent to file a full patent — for the technology.

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