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Locally made low-cost device reduces stillbirths by half

Researchers at the University of Pretoria (UP) have just finished testing a device that could prevent thousands of still births every year. The Umbiflow is a low-cost, low-tech device that detects problems with pregnancies in otherwise healthy women, and ensures that they get the care they need for a healthy birth, before it’s too late.

The Umbiflow was developed in 2005 by the Council for Scientific and Industrial Research (CSIR), in partnership with the Medical Research Council of South Africa (MRC). It is a low-cost alternative to commercially available ultrasound devices that measures the rate of blood-flow from the placenta to the fetus. Problems with blood flow means problems with pregnancy, says Dr Spencer Nkosi, a University of Pretoria researcher and medical doctor who is testing the Umbiflow device in the general population.

“The Umbiflow gives us a measure of placental function. After measurement, we group pregnant women into normal or abnormal placental function,” he says. “Women with abnormal function are directed to a high-risk clinic, where they get weekly or fortnightly checkups depending on our findings.”

Still births and other abnormalities are extremely high in South Africa and other developing countries, for reasons that are not altogether clear; in South Africa specifically, research from the Research Centre for Maternal, Fetal, Newborn and Child Health Care suggests that there are around 20 000 stillbirths every year. Many of these pregnancies seem completely normal, with mothers that appear healthy.

Nkosi explains: “One in ten healthy women that we scanned had an abnormal placental flow. Our question was, can Umbiflow help us identify fetuses at risk? When we did the trials in Mamelodi, we found that with Umbiflow we can reduce stillbirths almost by half.” Even more promising, the CSIR found and Nkosi confirmed that the device is as accurate as a commercial ultrasound machine, while being far cheaper and much easier to use. It is an ideal tool for hospitals in poor and rural areas that don’t have the resources of their urban counterparts.

The Umbiflow device uses a technology known as continuous wave doppler to measure the rate of blood  flow in the placenta, runs an algorithm, and outputs a value. The closer that value is to one, the lower the placental bloodflow is. A value of one represents a condition called absent flow, which means that the fetus is in real danger of dying.

According to Nkosi, absent flow was alarmingly common among the women in his study.

“Internationally, a low-risk population has absent flow in 0.3% of pregnancies; we found absent flow in 1.2%. That’s four times higher than the international reported average.”

Absent flow is commonly related to hypertension or developmental issues, but in Nkosi’s study these weren’t causing problems. He says he doesn’t yet know why this is occurring, and hopes that future research will provide an answer.

The next step in this research will be to test the Umbiflow on a national scale to see if it has the same positive results around the country. If so, Nkosi says this is a “eureka moment” for neonatal care in South Africa and the rest of the developing world.

A South African healthcare worker studies the readout from the Umbiflow device, a South African invention that helps detect risks with otherwise normal pregnancies. Image credit CSIR.

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