Design and evaluation of a low-cost sphygmomanometer to monitor women with pre-eclampsia in low-resource settings

  • Laura Causey Rice 360: Institute for Global Health, Rice University, Houston, Texas, USA
  • Sam Meja Department of Obstetrics and Gynecology, University of Malawi College of Medicine & Queen Elizabeth Central Hospital, Blantyre, Malawi
  • Edward Cleo Kommwa Department of Obstetrics and Gynecology, University of Malawi College of Medicine & Queen Elizabeth Central Hospital, Blantyre, Malawi
  • Phylos Bonongwe Department of Obstetrics and Gynecology, University of Malawi College of Medicine & Queen Elizabeth Central Hospital, Blantyre, Malawi; National Committee on Confidential Enquiry into Maternal Death, Malawi
  • Ronald Mataya Department of Obstetrics and Gynecology, University of Malawi College of Medicine & Queen Elizabeth Central Hospital, Blantyre, Malawi; School of Public Health, Loma Linda University, Loma Linda, California, USA
  • Ha Nguyen Department of Obstetrics, Gynecology and Reproductive Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, USA
  • Hector Mendez Figueroa Department of Obstetrics, Gynecology and Reproductive Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, USA
  • Erica Skerrett Rice 360: Institute for Global Health, Rice University, Houston, Texas, USA
  • Tyler Young Rice 360: Institute for Global Health, Rice University, Houston, Texas, USA
  • Kelley Maynard Rice 360: Institute for Global Health, Rice University, Houston, Texas, USA
  • Z Maria Oden Rice 360: Institute for Global Health & Department of Bioengineering, Rice University, Houston, Texas, USA
  • Rebecca Richards-Kortum Rice 360: Institute for Global Health & Department of Bioengineering, Rice University, Houston, Texas, USA https://orcid.org/0000-0003-2347-9467

Abstract

We developed and pilot tested a sphygmomanometer designed to monitor pregnant women in low-resource settings. Blood pressure was assessed in 138 subjects, including healthy adults (n=85), pregnant women (n=42), and women at-risk for pre-eclampsia (n=11) using the novel sphygmomanometer, manual auscultation, and the GE Dinamap Procare 400. Accuracy of the device was evaluated by comparing measurements of the test device and the Dinamap in healthy volunteers and pregnant women in Texas and in women at risk for pre-eclampsia in Malawi. Measurements from the test device in pregnant and healthy volunteer populations differed from those collected using the auscultatory method by 0.2 mmHg (95% CI: -18.8 to 19.2, systolic) and -2.8 mmHg (95% CI: -21.0 to 15.4, diastolic). In women at risk for pre-eclampsia, measurements with the test device differed from those of the Dinamap on average by 2.9 mmHg (95% CI: -29.3 to 35.1, systolic) and -5.4 mmHg (95% CI: -45.8 to 34.9, diastolic). Compared against the auscultatory method, measurements with the Dinamap differed on average by 0.0 mmHg (95% CI: -31.8 to 31.9, systolic) and -3.7 mmHg (95% CI: -28.6 to 21.3, diastolic). Accuracy was reduced when patients were moving or not seated during measurement. When testing the device against British Hypertension Society standards, the device achieved a grade of A/A in pregnant persons. This sphygmomanometer has the potential to provide low-resource hospitals with an affordable, accurate option for regular blood pressure monitoring. However, algorithm improvements are needed to reduce sensitivity to subject motion and posture.

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Published
2020-03-22
How to Cite
Causey, L., Meja, S., Kommwa, E. C., Bonongwe, P., Mataya, R., Nguyen, H., Mendez Figueroa, H., Skerrett, E., Young, T., Maynard, K., Oden, Z. M., & Richards-Kortum, R. (2020). Design and evaluation of a low-cost sphygmomanometer to monitor women with pre-eclampsia in low-resource settings. Global Health Innovation, 3(1). https://doi.org/10.15641/ghi.v3i1.836
Section
Research articles