Wearable Sensors for the Monitoring of Maternal Health – A Systematic Review

Abstract

Maternal health includes health during pregnancy and childbirth. Each stage during pregnancy should be a positive experience, ensuring that women and their babies reach their full potential in health and well-being. However, this cannot always be achieved. According to UNFPA (United Nations Population Fund), approximately 800 women die every day from avoidable causes related to pregnancy and childbirth, so it is important to monitor mother and fetal health throughout the pregnancy. Many wearable sensors and devices have been developed to monitor both fetal and the mother’s health and physical activities and reduce risk during pregnancy. Some wearables monitor fetal ECG or heart rate and movement, while others focus on the mother’s health and physical activities.

This study presents a systematic review of these analyses. Twelve scientific articles were reviewed to address three research questions oriented to (1) sensors and method of data acquisition; (2) processing methods of the acquired data; and (3) detection of the activities or movements of the fetus or the mother.

According to the research results, this study explores the potential of sensors in efficiently overseeing the health of both mother and fetus throughout pregnancy. Enhancing the precision, conducting trials in real-world scenarios, improving the user comfort of wearable sensors, and ensuring continual, long-term monitoring all necessitate further advancements in wearable sensor technology. Overcoming these obstacles could significantly aid in decreasing mortality rates associated with pregnancy complications and maternal health concerns.

The researchers noted that the majority of wearable sensors were utilized within controlled settings. They suggest that more extensive testing in real-life conditions and continuous monitoring are imperative before advocating for widespread adoption of these sensors.

Link to article below;

Wearable Sensors for the Monitoring of Maternal Health-A Systematic Review – PubMed (nih.gov)

 

Sudden cardiac arrest in athletes and strategies to optimize preparedness

Sudden cardiac arrest (SCA) is the leading cause of death in young athletes. Despite efforts to improve preparedness for cardiac emergencies, the incidence of out-of-hospital cardiac arrests in athletes remains high, and bystander awareness and readiness for SCA support are inadequate. Initiatives such as designing an emergency action plan (EAP) and mandating training in cardiopulmonary resuscitation (CPR) and automated external defibrillator use (AED) for team members and personnel can contribute to improved survival rates in SCA cases. This review provides an overview of SCA in athletes, focusing on identifying populations at the highest risk and evaluating the effectiveness of different screening practices in detecting conditions that may lead to SCA. This study summarizes current practices and recommendations for improving the response to SCA events, and highlights the need for ongoing efforts to optimize preparedness through the implementation of EAPs and the training of individuals in CPR and AED use. Additionally, it proposes a call to action to increase awareness and training in EAP development, CPR, and AED use for team members and personnel. To improve outcomes of SCA cases in athletes, it is crucial to enhance bystander awareness and preparedness for cardiac emergencies. Implementing EAPs and providing training in CPR and AED use for team members and personnel are essential steps toward improving survival rates in SCA cases.

Full Article;

Sudden cardiac arrest in athletes and strategies to optimize preparedness – PMC (nih.gov)

Sudden Cardiac Arrest in Basketball and Soccer Stadiums, the Role of Automated External Defibrillators: A Review.

Sudden cardiac arrest (SCA) during sports events has a dramatic impact on stadium-goers and the public and is often associated with poor outcomes unless treated with an automated external defibrillator (AED). Despite this, stadiums vary in AED use. This review aims to identify the risks and incidences of SCA, and the use of AEDs in soccer and basketball stadiums. A narrative review of all relevant papers was conducted. Athletes across all sports face an SCA risk of 1:50,000 athlete-years, with the greatest risk of SCA in young male athletes (1:35,000 person-years) and black male athletes (1:18,000 person-years). Africa and South America have the poorest soccer SCA outcomes at 3% and 4% survival. AED use on-site improves survival greater than defibrillation by emergency services. Many stadiums do not have AEDs implemented into medical plans and the AEDs are often unrecognizable or are obstructed. Therefore, AEDs should be used on-site, use clear signaling, have certified trained personnel, and be incorporated into stadiums’ medical plans.

 

For full study click below;

 

Sudden Cardiac Arrest in Basketball and Soccer Stadiums, the Role of Automated External Defibrillators: A Review. For the BELTRAN Study (BaskEtbaLl and soccer sTadiums: Registry on Automatic exterNal defibrillators) – PMC (nih.gov)

2022 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces

This is the sixth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. This summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscitation Task Force science experts. Topics covered by systematic reviews include cardiopulmonary resuscitation during transport; approach to resuscitation after drowning; passive ventilation; minimizing pauses during cardiopulmonary resuscitation; temperature management after cardiac arrest; use of diagnostic point-of-care ultrasound during cardiac arrest; use of vasopressin and corticosteroids during cardiac arrest; coronary angiography after cardiac arrest; public-access defibrillation devices for children; pediatric early warning systems; maintaining normal temperature immediately after birth; suctioning of amniotic fluid at birth; tactile stimulation for resuscitation immediately after birth; use of continuous positive airway pressure for respiratory distress at term birth; respiratory and heart rate monitoring in the delivery room; supraglottic airway use in neonates; prearrest prediction of in-hospital cardiac arrest mortality; basic life support training for likely rescuers of high-risk populations; effect of resuscitation team training; blended learning for life support training; training and recertification for resuscitation instructors; and recovery position for maintenance of breathing and prevention of cardiac arrest. Members from 6 task forces have assessed, discussed, and debated the quality of the evidence using Grading of Recommendations Assessment, Development, and Evaluation criteria and generated consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections, and priority knowledge gaps for future research are listed.

 

Full article linked below;

2022 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces | Circulation (ahajournals.org)

Prehospital and Hospital Care on Clinical Outcomes in Out-of-Hospital Cardiac Arrest

In recent years, several actions have been made to shorten the chain of survival in out-of-hospital cardiac arrest (OHCA). These include placing defibrillators in public places, training first responders, and providing dispatcher-assisted CPR (DA-CPR). In this study, they aimed to evaluate the impact of these changes on patients’ outcomes, including achieving return of spontaneous circulation (ROSC), survival to discharge, and survival with favorable neurological function.

Full article link below;

The Impact of Prehospital and Hospital Care on Clinical Outcomes in Out-of-Hospital Cardiac Arrest – PubMed (nih.gov)

Emerging technologies in wearable sensors

This aim of this article is to highlight some current challenges and emerging solutions in wearable sensors. Currently, investigation efforts are aimed at expanding the application scenarios and at translating early developments from basic research to widespread adoption in personal health monitoring for diagnostic and therapeutic purposes. This translation requires addressing several old and new challenges that are summarized in this article.  The special issue “Emerging technologies in wearable sensors” includes four selected contributions from leading researchers, exploring the topic from different perspectives. The aim is to provide the readers with a solid and timely overall vision of the field and with some recent examples of wearable sensors, exploring new research avenues.

For full article see link below;

Emerging technologies in wearable sensors – PMC (nih.gov)

Deployment of “super lay-rescuers” equipped with AED to improve OHCA survival: An innovative partnership between emergency medical service, city hall and a mobile application in France

Early defibrillation is a major determinant of survival in out-of-hospital cardiac arrest (OHCA). Shockable rhythms account for 18.7% of treated OHCA patients in emergency medical services (EMS), thanks to automated external defibrillators (AED). Shockable rhythms are strongly associated with improved survival rates compared to non-shockable rhythms in OHCA.

 

Defibrillation within 3–5 min of collapse can lead to survival rates as high as 50–70%.

 

Thus, reduced time between call to the emergency call centre (ECC) and AED using is a major issue.

 

Early recognition of OHCA and resuscitation performance with early defibrillation is the best way to increase survival chances. However, professional EMS arrive on site in about ten minutes in France.

 

The two steps to improve survival are one, to have volunteer rescuers on site quickly and two, to have them perform early defibrillation by an AED.

For the first step, notifying citizens as first responders to an OHCA event through a smartphone application with a mobile positioning system or a text message alert system increases early defibrillation and thereby improves survival.

 

The smartphone application SAUVLife© (Paris, France) currently used in France allows the ECC to solicit trained and registered lay rescuers. If you are connected and present in a one-kilometre perimeter around the victim, the application will alert and guide you to start CPR. It also warns another available lay-rescuer to a referenced AED and guides him to the victim.

 

In May 2022, a partnership between the EMS of the Angers University Hospital, the city of Angers, France and the SAUVLife© application was allowed to equip volunteer citizen rescuers with their own portable AED. These “super lay-rescuers” can be municipal staff, medical students or volunteers who agreed to always keep the defibrillator with them, day, and night. The geographical distribution of the portable AED in the 6 geographical districts of Angers resulted in homogeneous coverage of the city and rapid action regardless of the location of the OHCA.

 

With this innovative method, which is a first in France, aiming to increase AED usage before arrival of professional rescuers and to improve OHCA survival. This experiment should also allow to recruit more standard lay-rescuers and if successful, be extended to other areas.

 

References;

Deployment of “super lay-rescuers” equipped with AED to improve OHCA survival: An innovative partnership between emergency medical service, city hall and a mobile application in France – Resuscitation (resuscitationjournal.com)

Deployment of “super lay-rescuers” equipped with AED to improve OHCA survival: An innovative partnership between emergency medical service, city hall and a mobile application in France – PubMed (nih.gov)

Access to AED’s act in the USA

Congressman Higgins (Western NY) Announces Legislation Improving Access to AEDs

Introducing the Access to AEDs Act is a bill to support life-saving response to sudden cardiac arrest in student athletes. This bill was introduced following Damar Hamlin’s On-Field Cardiac Arrest in January of this year.

If passed, the legislation would create a federal grant program for schools to purchase, maintain, and provide training for automated external defibrillators and to create athlete screening programs, says the office of Rep. Brian Higgins (D-N.Y.). Funding can also be used to purchase and maintain AEDs, replace outdated CPR and AED equipment, and provide training to students, staff, and related sports volunteers.

Additionally, it can be used to develop Cardiac Emergency Response Plans and assist school athletic departments in creating heart screening programs for student athletes. The proposed legislation, would make AEDs and CPR training more accessible elementary and secondary schools across the country. Both public and private schools are included in this act.

 

For full press release see link below;

Congressman Higgins Announces Legislation Improving Access to AEDs | U.S. Representative (house.gov)

Functionality of registered Automated External Defibrillators

Aims: Little is known about automated external defibrillator (AED) functionality in real-life settings. This study aimed to assess the functionality of all registered AEDs in a geographically selected area and calculate the proportion of historical out-of-hospital cardiac arrests (OHCAs) covered by non-functioning AEDs.

Methods: In this cross-sectional study they inspected all registered and available AEDs on the island of Bornholm in Denmark. There was information collected on battery status (determined by AED self-test) and electrode status, as well as AED availability. All historical OHCAs registered with the Danish Cardiac Arrest Registry on Bornholm during 2016-2019 were identified and then the proportion of OHCAs covered by an AED was calculated (regardless of functionality status) within ≤100, ≤750, and ≤1800 meters and the proportion of OHCAs covered by non-functioning AEDs.

Conclusion: Almost one-fifth of all registered and publicly available AEDs were not functional, primarily due to expired electrodes, failed self-tests or obstacles to retrieving AEDs. One in twenty historical OHCA was covered by a non-functional AED. Although general AED functionality was high, this finding underlines the importance of regular AED maintenance.

Link to full study;

Functionality of registered automated external defibrillators – Resuscitation (resuscitationjournal.com)

 

Functionality of registered automated external defibrillators – PubMed (nih.gov)

Optimising outcomes after Out-of-Hospital Cardiac Arrest with Innovative approaches to Public-Access Defibrillation: A Scientific Statement from the International Liaison Committee on Resuscitation

Out-of-hospital cardiac arrest is a global public health issue experienced by approximately 3.8 million people annually. Only 8% to 12% of these people survive to hospital discharge. Early defibrillation of shockable rhythms is associated with improved survival but ensuring timely access to defibrillators has been a significant challenge.

To date, the development of public-access defibrillation programs, involving the deployment of automated external defibrillators into the public space, has been the main strategy to address this challenge. Public-access defibrillator programs have been associated with improved outcomes for out-of-hospital cardiac arrest; however, the devices are used in <3% of episodes of out-of-hospital cardiac arrest. This scientific statement was commissioned by the International Liaison Committee on Resuscitation with 3 objectives:

(1) identify known barriers to public-access defibrillator use and early defibrillation,

(2) discuss established and novel strategies to address those barriers, and

(3) identify high-priority knowledge gaps for future research to address.

The writing group undertook systematic searches of the literature to inform this statement. Innovative strategies were identified that relate to enhanced public outreach, behaviour change approaches, optimisation of static public-access defibrillator deployment and housing, evolved automated external defibrillator technology and functionality, improved integration of public-access defibrillation with existing emergency dispatch protocols, and exploration of novel automated external defibrillator delivery vectors.

This study provides evidence- and consensus-based policy suggestions to enhance public-access defibrillation and guidance for future research in this area.

References;

Optimizing Outcomes After Out-of-Hospital Cardiac Arrest With Innovative Approaches to Public-Access Defibrillation: A Scientific Statement From the International Liaison Committee on Resuscitation | Circulation (ahajournals.org)

Optimizing Outcomes After Out-of-Hospital Cardiac Arrest With Innovative Approaches to Public-Access Defibrillation: A Scientific Statement From the International Liaison Committee on Resuscitation – PubMed (nih.gov)