Bhutan and the Japan International Cooperation Agency (JICA) are building and improving health-related data banks to digitalise Bhutan's health system.
Safe and Secure delivery to mothers all over the world!
Japan’s perinatal and expectant mother’s mortality rate is among the lowest in the world, indicating the advanced medical practices of Japanese perinatal care. However, a decreasing number of obstetricians and increase of late childbearing has made the perinatal care situation much difficult, especially in the rural and remote areas including outer islands where obstetricians and midwives are limited in number resulting expectant mother’s care critical.
Telemedicine cardio-toco-graph and perinatal eHealth platform were developed so that doctors in distant locations can diagnose a condition of expectant mothers and fetus no matter where they are. Cardio-toco-graph “Petit Mobile CTG”, which is a medical device loaded with ICT technologies, has been used in clinical trials at many hospitals in Japan as well as in developing countries, and training of medical staffs was conducted in those locations.
An establishment of an operational structure to utilize present system is on its way in developing countries (Thailand, Laos, Indonesia, South Africa, Myanmar) where the mortality of expectant mothers and fetuses remain high and suffers low perinatal examination rate. By implementing this platform, it is expected to raise the examination rate that uses CTG, which currently is very low, leading to a significant decrease in the perinatal mortality rate.
Background history
In 1974, Our company’s advisers, Professor Kazuhiro Hara and Professor Yasuhito Takeuchi developed a cardiotocomonitor based on “a theory of real-time autocorrelation”. Their technological breakthrough became a world standard, making this principle to be implemented in virtually all the cardiotocomonitor in the world since then.
Melody International Ltd. developed “iCTG”, which is the smallest cardiotocomonitor in the world that uses a principle of “a real-time autocorrelation”. Despite its size, iCTG has exact same functions as conventional machines. It has been approved by the Pharmaceuticals and Medical Devices Agency of Japan (Approval Number 230AFBZX00024000). Up until now, such devices were available only inside the hospital, but iCTG’s portability allows it to be used at any location.
It is also designed in a manner that even non-medical personnel can use it easily.
1. Small
Small, Light-weight, and wireless – decreasing expectant mother’s stress
Transducer’s weight is close to that of common smartphones (166g / 137g). When compared to other conventional devices, iCTG’s volume and mass are less than 1/30. It only consists of two transducers and tablet for displaying results, getting rid of burdensome big machines and printers that are carried by a cart.
It is completely wireless, and once a tablet is connected to wifi or 3G/LTE network, an expectant mother can move around freely. Measurement can be done both inside and outside of hospital facilities. During hospital’s busy times, expectant mothers can receive NST exam while they wait, decreasing a stress of waiting for long time, and allowing doctors to better manage and use their time efficiently. Because it is wireless, there is no worry of cable deterioration.
・One full charging ( about 1 hours) will allow up to 6 hours of measurement. A quick recharging will allow medical personnel to feel safe and secure in busy time.
2. Smart
・Easy to find a fetal heart rate – a heart sound can be heard from transducer
Heart shaped transducer emits a fetal heart sound, allowing users to find fetal heart location intuitively. Even an untrained person can detect it easily, making this device an optimum choice for education purpose as well.
・Tablet and paperless display – Easy to check and reduces expense
A conventional tablet is used to display CTG graph. It operates on IOS, Android, and Windows devices, and all you have to do is to pair the tablet with transducers via Bluetooth. Measured data can be checked by scrolling a screen, assisting doctors’ quick decision making. Data are securely stored in a server (within a facility or cloud), providing sense of safety. There are no burden of storing graph papers and managing paper expenses.
・Sending data via internet – doctors can analyze data anywhere
After measurement is done, data is transmitted via internet to doctors’ smartphone, tablet and/or PC, and can be simply checked on any internet browser. This convenience will allow doctors to utilize their time productively in midst of their demanding schedule.
Even if no one is able to analyze at the place of measurement, it can be analyzed from a distant location. Expectant mothers who had to travel to secondary or tertiary facilities equipped with conventional CTG device to receive NST exam can now receive a same quality exam at primary care facilities using iCTG, and allow specialized doctor at distant hospital to analyze and diagnose the result. Expectant mothers will be free from a burden of having to travel long distance.
3. Simple
・Only two buttons on transducers – straight forward usages
Once the pairing of devices with a tablet is done, measuring can be started. On fetal heart rate monitor, there are only two buttons, which are power and volume button. On uterus contraction monitor, there are also only two buttons, which are power and zero-set button. Volume change and zero-set can be controlled from the tablet as well. Such simplicity allows smooth utilization of a device even for a beginner.
With its water drop proof rating of IPX2, transducer can be cleaned with no trouble.
4. Safe
Having passed a strict medical device approval, iCTG is a trustworthy device that is being used in well known hospitals in Japan. It is suitable for frequent and long monitoring of high risk pregnancy such as late child bearing and preterm labor. Expectant mothers with risk factors can be monitored at home by wearing this device, while the doctors analyze the result from elsewhere. By screening closely, a quick intervention will become possible, decreasing a risk for unexpected emergency delivery as a result.
Loading iCTG on the emergency vehicles (i.e. ambulance, helicopter) will enable data to be sent to doctors and to monitor the condition while being transferred. Hearing heartbeat of a fetus will ease the stress of a mother on board, reducing a chance of experiencing a panic attack. Additionally, by receiving data in an advance, accepting hospital can prepare a treatment plan before arrival, increasing a likelihood of saving a life.
6. Success
iCTG is also used in Chiang Mai, Thailand, and it has been successful. Cooperation between a hospital with specialized doctors and hospitals without such personnel was made possible by introducing iCTG to increase the antenatal checkup rate in order to find mothers with high risk pregnancy earlier and transfer them, contributing to higher chance of survival for expectant mother and fetus.
In reflection to such contribution, Chiang Mai University, who was the main partner in collaborating project, has been awarded a Thailand Public Service Award 2017 from the Office of the Public Sector Development Commission. Currently, this project is broadening to cover entire provincial hospitals of Chiang Mai.
