Tapping into foetal distress key to knowing safe window for delivery

Australia’s stillbirth rate hasn’t changed in 20 years, but new devices developed by Melbourne researchers have sparked hope this number could be turned around.

Obstetrician Dr Julia Francis with her two sons, Isaac, aged 20 months, and Elliot, 4. Picture: David Caird

Melbourne researchers are developing two devices to measure an unborn baby’s stress levels in a bid to reduce stillbirths and labour complications.

A prototype fibre-optic sensor, currently being tested on animals, can directly measure foetal distress and pinpoint when a baby should be born.

Every day, six Australian babies die after 20 weeks gestation, a stillbirth rate that has remained unchanged for about 20 years despite advances in medical care and research.

Monash Health obstetrician Dr Julia Francis, pictured with 20-month-old son Isaac, is pregnant with her third child. Picture: David Caird

Lead researcher Dr Fiona Brownfoot, a clinician scientist at Mercy Health and University of Melbourne, said the day we are born was one of the most risky days of our life, but there were currently only indirect ways of measuring how a baby was coping in the womb.

“Labour is a very stressful time for a baby,” Dr Brownfoot said.

“Every time there is a contraction that limits the amount of blood supply to the baby.

“Most babies have a good reserve and can tolerate contractions, but some can’t; they get stressed and starved of oxygen.

“If you can pick the exact moment a baby is stressed then you can deliver them and reduce the risk of complications of asphyxia, cerebral palsy and death.

“Equally, by having a more direct measure of foetal distress it can also hopefully prevent jumping in with a caesarean section, when the baby is actually coping quite well.”

Dr Francis is hopeful a new device measuring a baby’s stress levels can help reduce stillbirth statistics. Picture: David Caird

Teaming with university engineers, the obstetrician has developed a prototype fibre-optic sensor to be inserted vaginally in the mother and directly measures a baby’s stress levels.

“About 30 per cent of pregnancies are delivered due to worry about foetal distress,” she said.

“We hope this device can help us only delivering babies when they’re truly distressed, and equally not missing the critical point to deliver safely without consequence.”

The second device they are developing is a portable ECG heart monitor, which the prospective mother would wear on her stomach in the weeks or days before birth.

Unlike current technology that picks up the foetal heart rate just 40 per cent of the time, this device can cut through the noises of the mother’s heartbeat and digestive tract, to accurately assess the baby’s heart rate.

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The electronic would alert the mother and hospital if the baby was distressed.

Julia Francis, a Mercy Health obstetrician who is 36 weeks pregnant with her third child, said

“The onus is on mums to report foetal movement. That’s really all we have,” Dr Francis said.

“In so many cases we have no warning of a stillbirth and we miss the perfect window of opportunity to deliver them. If there was a device to find that, it would hopefully let us reduce those stillbirth statistics.”