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Title: Evaluation of an external fetal electrocardiogram monitoring system: A randomized controlled trial

Authors: Martha Monson, MD; Cara Heuser, MD; Brett D. Einerson, MD, MPH; Isaac Esplin, BS; Greg Snow, Ph.D.; Micheal Vamer, MD; M. Sean Esplin, MD

Date Published: August 2020

Affiliations:

Intermountain Healthcare: Martha Monson, MD; Cara Heuser, MD; Brett D. Einerson, MD, MPH; Greg Snow, Ph.D.; Micheal Vamer, MD; M. Sean Esplin, MD

University of Utah Health: Martha Monson, MD; Cara Heuser, MD; Brett D. Einerson, MD, MPH; Micheal Vamer, MD; M. Sean Esplin, MD

Brigham Younf University: Issac Esplin, BS

Title: Relative accuracy of computerized intrapartum fetal heart rate pattern recognition by ultrasound and abdominal electrocardiogram detection

Authors: Barrie R. Hayes-Gill, Terence R. P. Martin, Chong Liu, Wayne R. Cohen

Date Published: March 2020

Affiliations:

University of Nottingham: Barrie R. Hayes-Gill, Chong Liu

Monica Healthcare, Ltd.: Terence R. P. Martin

University of Arizona College of Medicine: Wayne R. Cohen

Paid consultant by Monic Healthcare, Ltd. and GE Healthcare: Wayne R. Cohen

Study was funded by Monica Healthcare, Ltd.

Title: Implementation of the combined use of non-invasive fetal electrocardiography and electrohysterography during labor: A prospective clinical study

Authors: Maria W.E. Frenken, Daisy A. A. Van Der Woude, Rik Vullings, Swan G. Oei, Judith O. E. H. Van Laar

Date Published: March 21, 2023

Affiliations:

Maxima MC: Maria W. E. Frenken, Daisy A. A. Van Der Woude, Swan G. Oei, and Judith O. E. H. Van Laar

Eindhoven University of Technology: Maria W.E. Frenken, Daisy A. A. Van Der Woude, Rik Vullings, Swan G. Oei, Judith O. E. H. Van Laar

Nemo Healthcare B.V.: Swan G. Oei and Rik Vullings

Funded by Nemo Healthcare B.V.

Title: Novii+ Wireless Patch System

Author: GE Healthcare

Date Published: Unknown, accessed May 25, 2024

Affiliations: Bias due to the company selling this product.

Title: The difference between TOCO and EMG labor monitoring: Improving patient care

Authors: GE Healthcare

Date Published: February 28, 2024

Affiliations: Bias due to the company selling this product.

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Healthcare is continuously being improved by the use of new technologies. One of the newest pushes of healthcare technologies it to make patient monitoring systems wireless. One of the biggest new innovations in wireless technology is within the realm of healthcare during labor. GE HealthCare has created the Novii+ Wireless Patch System to monitor both the mother and the fetus during labor (Novii Wireless Patch System, n.d.). The system consists of a wireless patch that attaches to the mother's stomach that connects via bluetooth to a device that shows the mother's heart rate, the fetus's heart rate, and uterine electromyography (Novii Wireless Patch System, n.d.). This device has several benefits as seen in the Pros section, as well as dome drawbacks as seen in the cons section.

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Novii Wireless Patch System | GE Healthcare

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Able to use in multiple labor positions (Monson et al., 2020)

Placement is not dependent on fetal position (Monson et al., 2020)

Monitors both maternal and fetal heart rate (Monson et al., 2020)

Proven to produce more readable strips than traditional TOCO devices (Monson et al., 2020)

Proven to have less device adjustments when compared to traditional TOCO devices (Monson et al., 2020)

Can be used in patients with high BMIs (Monson et al., 2020)

Studies show that it can help decrease invasive monitoring methods during labor (Frenken et al., 2023)

Less likely to show false accelerations and decelerations (Hayes-Gill et al., 2020)

Data from wireless monitors is more similar to invasive monitoring techniques than traditional TOCO monitors (Hayes-Gill et al., 2020)

Able to use during ambulation (GE HealthCare, 2024)

Water proof (GE HealthCare, 2024)

Can continue to monitor the fetus during epidural placement (Novii Wireless Patch System, n.d.)

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Unable to use if have a sensitivity to adhesive (Monson et al., 2020)

Found to have more issues with the device - setting up or failure for device to connect (Monson et al., 2020)

Cannot measure contraction strength (Monson et al., 2020)

During the pushing stage of labor, signal could be disrupted (Frenken et al., 2023)

Needs staff training to set up correctly/comfortability with the device (Frenken et al., 2023)

Hospitals will have to install new devices/alarm systems (Frenken et al., 2023)

Cannot be used before 34 weeks of gestation (Novii Wireless Patch System, n.d.)

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In my opinion, this innovation will be used widespread within the next few years. It allows for more close monitoring of both the mother a fetus, and it can prevent the use of invasive monitoring which can lead to further complications. It is also useful to distinguish between the maternal and fetal heart rates which traditional TOCO can mistake the mother's heart rate for the fetal heart rate. I think this innovation will also make laboring mother's happier as they will be able to ambulate and change positions with ease. While I do support this innovation and I think it will be a great contribution to hospitals, I do have a couple hesitancies. For one, it will take time to train staff on the new equipment. Hospitals might also have to re-wire the unit to add in alarms for the new monitors. Both training staff and re-wiring are both time consuming and costly, so I believe that it might take a little while for the monitors to become more widespread. However, I do think the cost is worth it in order to increase safety, decrease complications related to invasive monitoring, and increase patient satisfaction.

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Team member 1: Angelica - Analytical

I believe that Angelica will be a good addition to the team because she will be able to analyze the cost behind the project and the statistics behind why this project would be good to execute.

Team member 2: Carter - Communication

I believe that Carter will be a good addition to the team because he will be able to effectively present the project to others. He can help prove the benefit of the innovation and get the project approved.

Team member 3: David - Deliberative

I believe that David would be a good addition to the team because he will be great at planning out the project and recognizing if there are any obstacles that the project will need to overcome.

Team member 4: Fernando - Focus

I believe that Fernando will be a good addition to the team because he can prioritize tasks. He can also make sure that people are staying on task and ensure that the project is getting done in a timely manner.

Team member 5: Randall - Responsibility

I believe that Randall will be a good addition to the team because he can be a person to rely on to complete tasks. He can also influence other people on the team to continue working.

My strengths: Includer, woo, learner, achiever, arranger

I believe that my strengths will fit in well with the team I have created. With my includer and woo strengths, I will be able to get to know people on the team and bring everyone together to get to know each other and help them to work well together. Because I am a learner, this will help me to do research on the project to be included in the presentation. I also have the strength of achiever, which will help motivate me to complete the project. Finally, my ability as a arranger will help me to recognize the steps to complete the project and delegate tasks to the right person on the team.

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Frenken, M. W. E., Van Der Woude, D. A. A., Vullings, R., Oei, S. G., & Van Laar, J. O. E. H. (2023, March 21). Implementation of the combined use of non-invasive fetal electrocardiography and electrohysterography during labor: A prospective clinical study. Acta Obstetricia et Gynecologica Scandinavica, 102(7), 865 - 872. 10.1111/aogs.14571

GE HealthCare. (2024, February 28). The difference between TOCO and EMG labor monitoring: Improving patient care. https://clinicalview.gehealthcare.com/article/difference-between-toco-and-emg-labor-monitoring-improving-patient-care

Hayes-Gill, B.R., Martin, T. R. P., Liu, C., & Cohen, W. R. (2020, March). Relative accuracy of computerized intrapartum fetal heart rate pattern recognition by ultrasound and abdominal electrocardiogram detection. Acta Obstetricia et Gynecologica Scandinavica, 99(3), 413 - 422. 10.1111/aogs.13760

Monson, M., Heuser, C., Einerson, B. D., Esplin, I., Snow, G., Vamer, M., & Esplin, M. S. (2020, August). Evaluation of an external fetal electrocardiogram monitoring system: A randomized controlled trial. American Journal of Obstetrics and Gynecology, 223(2), 244e1 - 244e12. 10.1016/j.ajog.2020.02.012

Novii wireless patch system. (n.d.). GE HealthCare. Retrieved May 25, 2024, from https://www.gehealthcare.com/products/maternal-infant-care/fetal-monitors/novii-wireless-patch-system?utm_medium=cpc&utm_source=google&utm_campaign=USC-USC-PCS-AlwaysOn-COV-SC&utm_term=wireless%20fetal%20monitors&utm_content=12207541875&npclid=Cj0KCQjw0ruyBhDuARIsANSZ3wrbtDOuER5ZeC27cf8y7RefbQHYKOzE4IIDE02zeKqJejzQKnGN8kcaAkfNEALw_wcB&gad_source=1&gclid=Cj0KCQjw0ruyBhDuARIsANSZ3wrbtDOuER5ZeC27cf8y7RefbQHYKOzE4IIDE02zeKqJejzQKnGN8kcaAkfNEALw_wcB