Cardiovascular disease is the leading cause of mortality and morbidity in the United Arab Emirates, but researchers in the Healthcare Engineering Innovation Center at Khalifa University are working on all aspects of heart health care to ensure citizens and residents at all stages of life are looked after. This includes the latest product from the successful sponsorship and establishment of a UAE-based biomedical company in cardiac monitoring from Dr. Ahsan Khandoker, Associate Professor of Biomedical Engineering at Khalifa University. The product focuses on pregnancy and fetal heart health as a home-based monitoring device for pregnant mothers and their babies, named Twinkle Heart.
The monitoring device comprises four fetal phonocardiogram (FPCG) sensors held on the maternal abdomen by a square fabric harness and elastic belts. “The center of the harness is placed over the mother’s umbilicus, which places the four sensors at equidistance from the center,” explained Dr. Khandoker. “This gives a very reliable measurement of fetal and maternal heart sounds, but without the need for operator skill in where to place the sensors.”
The novel device makes it easier for women who may be worrying about their baby to monitor its cardiac activity, and also helps mothers simply listen to their baby’s heartbeat and feel connected and reassured.
Beyond the home-based application, the device’s portability makes it an ideal solution for health workers in remote areas to monitor cardiac health in pregnancy.
“The device adapts to a mobile phone’s audio port to capture the four-channel FPCG signals so the app we developed can perform the data analysis,” said Dr. Khandoker. “The mobile phone interface app is user-friendly to provide point-of-care decision support to pregnant mothers as well as health workers in remote areas.”
“The Healthcare Engineering Innovation Center (HEIC) seeks to develop novel methodologies, devices and tools for the diagnosis, intervention and rehabilitation of the wide spectrum of health challenges associated with cardiovascular disease,” explained Dr. Cesare Stefanini, Associate Professor of Biomedical Engineering and Director of the HEIC. “Cardiovascular disease is the leading cause of mortality and morbidity in the United Arab Emirates, making our work crucial for the citizens and residents here. The HEIC collaborates with leading healthcare providers and regulators in the UAE to define and build population-specific, clinically implementable, and innovative approaches and engineering solutions.”
It is evident from recent research that common diseases such as cardiovascular disease, metabolic syndrome, atherosclerosis, and Type 2 diabetes in adult life are associated with adverse influences during fetal development. The fetal origins of cardiovascular disease, in particular, state that fetal undernutrition in middle to late gestation—which leads to disproportionate fetal growth—becomes permanently programmed into coronary heart disease in adult life.
“This anomaly highlights the need to develop more effective ways of identifying ‘at-risk’ fetuses at home in ‘low-risk’ groups who are not seriously monitored,” said Dr. Khandoker. “Therefore, it is imperative to develop simple-to-manage, easy-to-use home screening processes that can monitor all risk groups at the first point of obstetric contact and achieve very high perinatal detection rate of cardiac abnormalities.”
Fetal heart rate is commonly measured on the labor ward and during pregnancy to monitor the health of the fetus and requires training and skill to perform accurately. While the prenatal products market has seen an influx of fetal heart monitoring devices, concerns have been raised over the incorrect use of such products. Doppler ultrasound devices and sound amplifying monitors do no harm to the baby, but there are concerns that their use risks mothers delaying seeking medical attention and suffering from false reassurances.
“It’s true that pregnant mothers at home could possibly misinterpret vital signs. That’s why our device includes a sophisticated diagnostic algorithm that can recognize whether a baby is sick,” explained Dr. Khandoker. “The algorithm takes the vital signs from fetal and maternal heart sounds, and then classifies them into three categories: No worries; Caution with check again; and Call Hospital. This solution can also run on mobile platforms as well as a hospital cloud service connecting directly to medical professionals.
“Now, a mother does not need to have any technical expertise to be able to make the decision on whether to seek medical attention—she can simply listen to her baby’s heart for the emotional connection that provides.”