Evaluation of the introduction of a novel device in the management of hypertension and shock in pregnancy in low-resource settings

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Every day, approximately 800 women die in pregnancy or childbirth. 99% of all of these deaths occur in the developing world, with women in rural communities, with limited access to healthcare, at the greatest risk. The leading causes of death in these women include severe bleeding, overwhelming infections, and blood pressure problems. It is widely recognised that many women die in pregnancy because the problem is recognised too late. In all of these instances, simply monitoring women's blood pressure and pulse could be lifesaving. A woman would be recognised as being unwell and appropriately treated before serious, irreversible complications set in. In the developing world many healthcare providers do not have access to working blood pressure devices. Many devices that are available are often inaccurate in pregnancy, particularly in women with BP problems. This means that unwell women go unrecognised and treatment is either delayed or not given, which can result in serious illness and even death.We have developed a simple, accurate, handheld device to measure blood pressure and pulse. This device has some special features that make it ideal for use in the developing world. It does not require medically training and anyone can use the device with minimal skill. This makes it ideal for use in communities, particularly rural settings, where untrained health workers commonly visit women and their babies. Another special feature is the 'traffic light' system; the device tells the user if the blood pressure and pulse measurements are normal (green), worrying (amber) or severely abnormal (red). This enables the device to signpost women who are unwell, or becoming unwell, to untrained observers. This will enable more appropriate and early referral to higher-level care. The device has been tested extensively and is shown to be accurate in pregnant women, even those with blood pressure problems. The device can be charged through a regular mobile phone charger, has a long power life and a large easy-to-read screen. The device is cheap at less than 20 euros.Through our previous work in rural community settings in Africa, we know that there is a need for access to blood pressure devices; many clinics have no access to working, accurate machines. This project will improve access for women to have accurate measurements of their blood pressure and pulse (a fundamental part of care for women in pregnancy). Our project intends to put these simple devices into communities with the aim of improving detection of pulse and blood pressure problems. By highlighting those who are unwell, we hope use of the device will lead to more women receiving the best, most appropriate care and fewer women dying or becoming seriously unwell from these devastating diseases.