Wearable sensors for prediction of intraamniotic infection in women with Preterm Premature Rupture of Membranes

Background Preterm premature rupture of membranes (PPROM), defined as rupture of the membranes before 37 weeks of gestation, can lead to intraamniotic infection and consequently preterm delivery can be necessary. It remains one of the major unsolved obstetric problems to predict which women will develop an intraamniotic infection, needing to be delivered prematurely, and which will not.

Wearable sensors using photoplethysmographic technology are increasingly used in medicine for continuous monitoring of physiological parameters. Although previous studies suggest that patterns of physiological activity may be used for early detection of infection and systemic inflammation in the general population, few studies have examined the application of wearable devices in pregnant women.

Objective: to evaluate the use of wearable sensors for prediction of intraamniotic infection in pregnant women with PPROM

Methods In a prospective proof of principle study, we included 50 patients diagnosed with PPROM at the University Hospital Zurich between November 2017 and May 2020. Patients were instructed to wear a bracelet during the night, which measures several physiological parameters including wrist skin temperature, heart rate, heart rate variability and breathing rate. A two-way repeated measures ANOVA was performed to evaluate the difference over time of both the wearable device measured parameters with the bracelet and the standard clinical monitoring values such as body temperature, pulse, leucocytes, CRP between women with intraamniotic infection compared to those without.

Results The median gestational age (GA) at PPROM was 30.7 weeks of gestation (223 days, interquartile range [IQR] 197 to 234); the median GA at delivery was 32.9 weeks of gestation (236 days, IQR 220 to 247). 23 patients (46%) were diagnosed with intraamniotic infection. Regarding the physiological parameters measured with the bracelet, we observed a significant difference in breathing rate (19 vs. 16 per minute, p<0.01) and heart rate (72 vs. 67 beats per minute, p=0,03) in women with intraamniotic infection compared to those without during the 3 days prior to birth.

The standard clinical monitoring values were significantly different in the intraamniotic infection group compared to women without infection in the three days preceding birth.

Conclusion Our results suggest that wearable sensors might be a promising, noninvasive, patient friendly approach to support the early detection of intraamniotic infection in women with PPROM. However, large scale studies would be needed to confirm our findings before implementing this technique in the standard clinical management of these women

Publication History

Article published online:
26 November 2021