PRE-ECLAMPSIA RISK ASSESSMENT IMPROVES WITH PULSE OXIMETRYBeth Payne, PhDPostdoctoral Fellow, UBC

PRE-ECLAMPSIA

• Pre-eclampsia – defined by high blood pressure and protein in the urine during pregnancy

• Second leading cause of maternal death– 30,000-50,000 maternal deaths annually

• Perinatal deaths largely due to increased incidence of preterm birth associated with disease

• Deaths could be prevented with access to effective antenatal care and timely intervention

Why does it matter?

• Mobile phone based decision aid for community health workers combining:– Validated risk

assessment model– Mobile pulse oximetry

• Supports task-shifting of evidenced-based antenatal care to existing community health workers, improving access to effective ANC

OUR PROPOSED SOLUTIONPIERS on the Move

• Guides community health worker through antenatal assessment and provides recommendations for follow-up care based on risk model

PIERS ON THE MOVESupporting healthcare decision making in the community

• How important is pulse oximetry for risk assessment?• Low SpO2 increases risk of complications 30-fold– additional 18.5% of women with complications being

correctly identified as high-risk• Correctly identifying risk prior to complications will

save lives!(Payne et al. JOGC 2015)

PULSE OXIMETRY FOR PRE-ECLAMPSIA

• How important is pulse oximetry for risk assessment?– Low SpO2 increases risk of complications 30-fold– Correctly identify additional 18.5% of women as high-

risk• Correctly identifying risk prior to complications

ensures timely access to care and saves lives!(Payne et al. JOGC 2015)

PULSE OXIMETRY FOR PRE-ECLAMPSIA

IMPLEMENTATION AT SCALECommunity Level Interventions for Pre-eclampsia (CLIP)• Cluster randomized controlled trial in Mozambique, Pakistan and India• Assessing impact of PIERS on the Move tool on maternal and perinatal outcomes• https://pre-empt.cfri.ca/

Peter von DadelszenMark AnserminoGuy DumontDustin DunsmuirGarth CloeteJoanne LimDavid HallErika van PapendorpCLIP study teamThe nursing and midwifery staff at Tygerberg Hospital POM study participantsGrand Challenges Canada, Bill & Melinda Gates FoundationOther funders:CIHR, WHO, CFRI, MSFHR, UBC, USAID, Preeclampsia Foundation, FIGO, Rockefeller Foundation

THANK YOU!