A Diva to manage mum's blood pressure

SINGAPORE - An autimatic system to manage blood pressure in mothers going through caesarean births has been developed by doctors at a Singapore hospital, in what they say is a world first.

The Double Intravenous Vasopressor Automated System - or Diva - is still in development stage, but doctors at the KK Women's and Children's Hospital (KKH) hope it will lead to safer caesarean sections.

About 30 per cent of patients at the hospital, which delivers 30 to 35 babies every day, undergo caesarean births.

Not only does Diva allow hands-off and more accurate blood pressure and heart rate monitoring, but - through a computer programme - it also delivers the precise amount of medication needed to stabilise the patient more quickly.

"The baby's blood pressure and oxygen supply is very dependent on the mother's blood pressure, so it's important to regulate it," said Dr Sng Ban Leong, a consultant at KKH's Department of Women's Anaesthesia.

Up to 60 per cent of expectant mothers experience low blood pressure under spinal anaesthesia. This could cause pre-delivery nausea and, in more severe cases, it reduces blood flow to the placenta - harming the baby.

Until the development of Diva, managing blood pressure levels required an anaesthetist to manually administer vasopressors, which raise blood pressure by constricting blood vessels.

Now, blood pressure and heart rate data can be sent to a laptop from two finger cuffs worn by the patient, and a programme will determine the dosage of vasopressor needed.

The speed at which it reacts is faster than conventional monitoring, which occurs at 60-second intervals and could delay the detection of rapid changes in blood pressure.

Diva also frees up the anaesthetist to do other things.

"With this automated close- loop system, the anaesthetist is able to focus on more important aspects of patient care - to deliver more holistic patient care," said Professor Alex Sia, chairman of the medical board and director of KK Research Centre.

A 2011 study, jointly carried out by KKH and Duke-NUS Graduate Medical School and involving 55 women, showed that the Diva system was more efficient than conventional methods at maintaining blood pressure during caesarean sections under spinal anaesthesia.

KKH, however, could not give a timeframe as to when Diva will come into operation.


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