PIERS on the Move - transitioning from pre-eclampsia to pregnancy and neonatal care

Organization: 
University of British Columbia
Organization Location: 
Vancouver, BC, Canada

Every day, 750 pregnant women, 7200 fetuses, and 8200 newborns die - almost uniformly from preventable causes. Over 99% of those deaths occur in less developed countries, often shortening the lives of individuals who have been unable to access effective health care (either at all or in time). Generally, women die from complications of pregnancy and childbirth that lead either to low (bleeding, prolonged labour, and sepsis) or high (hypertension) blood pressure, as well as intercurrent illnesses (HIV, malaria, and tuberculosis). Causes of stillbirth and newborn death include complications of labour, infection and congenital heart disease. We have developed the PIERS on the Move (POM) mHealth smart phone platform that includes audio-oximetry to accurately identify risk and guide home- and evidence-based health care interventions by community health care providers (cHCPs) when pregnancies are complicated by hypertension (18.5% of maternal deaths, 5% of fetal/newborn deaths). Currently, while the POM app focusses on pregnancy hypertension, such integrated approaches do not exist for these other lethal pregnancy and newborn complications. Using existing information, and gathering vital new information when necessary, we will develop and validate an integrated panel of maternal, fetal and newborn risk stratification tools that incorporate pulse oximetry to supplement the POM platform, converting the P of PIERS from pre-eclampsiato pregnancy and pediatric. Integrating these models within the POM app will prepare the way to implement an integrated platform to guide care in women and newborn homes. Thereby, we will alter trajectories of disease that lead to avoidably foreshortened lives.

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