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AI technology could detect pregnancy-related heart disease

A digital stethoscope has been shown to identify twice as many cases of peripartum cardiomyopathy as compared to regular care

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An AI-enabled digital stethoscope could detect pregnancy-related heart disease, new research has shown.

The study, conducted by Mayo Clinic, has found that an AI-enabled digital stethoscope could improve the diagnosis of peripartum cardiomyopathy, a potentially life-threatening and treatable condition that weakens the heart muscle of women during pregnancy or in the months after giving birth.

Researchers used the AI-enabled digital stethoscope that captures electrocardiogram (EKG) data and heart sounds to identify twice as many cases of peripartum cardiomyopathy as compared to regular care.

“We demonstrated for the first time in an obstetric population that AI-guided screening using a digital stethoscope improved the diagnosis of this potentially life-threatening and treatable condition,” explained lead study author Demilade A. Adedinsewo, an assistant professor of medicine in the department of cardiovascular medicine at Mayo Clinic in Jacksonville, Florida.

“This research can change current clinical practice from one that is reactive and symptom-driven to a more proactive approach of identifying pregnancy-related cardiac dysfunction using a simple, low-cost and effective screening tool.

“Earlier diagnosis would facilitate prompt and appropriate management of cardiomyopathy and reduce associated disease and death.”

Peripartum cardiomyopathy is a type of heart failure that can affect women late in pregnancy or after pregnancy. The disease weakens the heart, resulting in a decrease in the amount of blood that is pumped from the heart to other parts of the body.

It is typically diagnosed towards the end of pregnancy or in the months following and may be difficult for health professionals to detect because many of the symptoms are similar to those seen with normal pregnancy, such as shortness of breath and swelling in the feet and legs, according to the American Heart Association.

The rate of peripartum cardiomyopathy is somewhat low in the US, affecting one in every 1,000 to 4,000 pregnancies. However, it is more prevalent in countries like Nigeria, which has the highest reported incidence of peripartum cardiomyopathy worldwide, with it impacting as many as one in 96 pregnancies.

As part of the study, researchers from Mayo Clinic looked at almost 1,200 Nigerian women who were pregnant or had recently had a baby.

Approximately half were evaluated with AI-guided screening using the digital stethoscope and half received usual obstetric care in addition to a clinical EKG. Peripartum cardiomyopathy was detected twice as often among study participants when EKG testing was performed with a digital stethoscope using an AI algorithm, compared to clinical EKG in addition to routine obstetric care.

Overall, four per cent of the pregnant and postpartum women in the intervention arm of the clinical trial had cardiomyopathy compared to two per cent in the control arm, suggesting that half are likely undetected with usual care.

“While we expected AI-guided screening to improve the diagnosis of cardiomyopathy, we did not anticipate the frequency of cardiomyopathy diagnosis would be doubled,” Adedinsewo said.

She added: “Additional large trials enrolling a diverse group of women in other geographic locations are needed to evaluate the impact of AI-guided screening on cardiomyopathy diagnosis as well as its impact on adverse maternal outcomes.”

Pregnancy

Pregnancy complications may increase risk for artery disease, study finds

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Pregnancy complications may increase women’s risk of peripheral artery disease later in life, new research suggests.

The study analysed data from more than two million women in Sweden who gave birth to single babies between 1973 and 2015.

Led by Casey Crump, the research examined the long-term risk of peripheral artery disease among women who experienced preterm delivery, pre-eclampsia, gestational diabetes or other adverse pregnancy outcomes.

Crump, professor in the department of family and community medicine at McGovern Medical School at UTHealth Houston, said: “Our prior work has already shown that adverse pregnancy outcomes are associated with long-term risks of heart disease, stroke, and heart failure.

“This study builds on that work by showing that these women have an increased risk of peripheral artery disease, an important but understudied cardiovascular condition.”

Peripheral artery disease is often a precursor to long-term cardiovascular complications, including stroke, ischaemic heart disease and premature death.

The condition affects millions of people worldwide and occurs when narrowed arteries reduce blood flow, most commonly to the legs and feet.

Ischaemic heart disease occurs when the heart does not receive enough blood and oxygen, usually because the arteries have narrowed.

Symptoms of peripheral artery disease can include leg pain, cramps while walking, numbness, cold feet and sores on the feet or legs that are slow to heal.

Crump said women who experience pregnancy complications have an important opportunity after giving birth to make plans with their primary care doctor to monitor long-term risks.

Women who have experienced complicated pregnancies should speak with their doctor about possible future cardiovascular health risks.

Checks for blood pressure, diabetes and cholesterol are important.

While the period after childbirth is an important time for women to monitor their health, Crump said it is never too late to lower the risk of peripheral artery disease.

He said: “Women with a history of adverse pregnancy outcomes who seem to be doing well may still have a higher risk that can emerge later in life.”

Crump also suggested preventive steps such as avoiding smoking, maintaining a healthy weight and following a healthy lifestyle.

He stressed the importance of long-term follow-up care and conversations with healthcare providers to help protect cardiovascular health later in life.

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New pregnancy treatment shows promise for at-risk twins

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A high-powered ultrasound treatment could help identical twins affected by a rare and serious condition during early pregnancy, an initial study suggests.

Twin-to-twin transfusion syndrome, or TTTS, causes uneven blood flow between identical twins who share a placenta.

The imbalance can leave one baby dangerously small and the other too large, putting both babies’ survival at risk.

 

Brioney Garrett’s daughters were in danger before doctors used the world-first treatment to seal the blood vessels causing the problem without an operation.

Nancy and Margo were born healthy and, now aged four, are due to start school.

Researchers from Queen Charlotte’s and Chelsea Hospital tested the non-invasive procedure in 10 women from the UK and elsewhere in Europe after scans detected TTTS during early pregnancy.

Five women needed further treatment, while 12 of the 20 babies survived following the procedure.

The researchers described having a treatment that did not require a needle or telescope to be inserted into the mother’s abdomen as “extremely exciting”.

However, they said larger studies involving more pregnant women were needed before the procedure could be offered more widely.

Garrett described her daughters as “my miracle twins”.

She said: “We were in a very dire situation and I don’t forget that.

“It stays with me always how things could have been. Every day I still count my blessings.”

TTTS affects between 10 and 15 per cent of identical twins who share a placenta, representing around 300 to 400 pregnancies in the UK each year.

The uneven blood flow causes excess fluid to build up around the larger recipient baby, while leaving dangerously little fluid around the smaller donor baby.

Treatment usually involves inserting a needle into the womb to drain some of the fluid or using a laser to seal the connecting blood vessels.

Garrett’s procedure took about 20 minutes. She lay flat while a specially designed machine directed high-powered ultrasound waves at small blood vessels in her placenta.

She said: “It was very quick and pretty painless.”

Christoph Lees, head of fetal medicine at Imperial College Healthcare NHS Trust and professor of obstetrics at Imperial College London, described the research as “very promising”.

He said: “If this could work in a fully-fledged study, it could give hope to a lot of women who otherwise might have to have quite invasive treatment.”

Ultrasound is commonly used during medical scans to produce images of the body, but this procedure uses much more focused waves.

Heat generated by the waves can seal blood vessels about 2mm in diameter and located around 5cm to 6cm beneath the skin.

The procedure blocked blood flow in 90 per cent of the vessels treated during the study, with no unwanted side-effects reported.

Twins Trust, which supported the study, said the approach could make a significant difference for families affected by TTTS.

Helen Peck, head of healthcare engagement and research, said: “Any procedure that is non-invasive and can potentially identify TTTS earlier and improve outcomes for our families with this life-threatening condition could be a turning point.”

Scans carried out weeks after Garrett’s procedure showed that blood flow between the babies had been rebalanced, although other problems developed during the pregnancy.

Garrett said Margo, who had too little fluid around her, “was in a much better position” and that “the strain on Nancy’s heart had eased”.

Nancy and Margo were born at nearly 34 weeks, weighing 3lb 7oz and 3lb 3oz respectively.

Garrett said: “They were both healthy, and Margo wasn’t as small as we worried she was going to be.”

The twins are due to start primary school in September.

Garrett said: “They’re funny, smart, energetic little girls that just fit right in with their age group.”

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Pregnancy

New reporting tool targets maternal-fetal teams as pregnancy complexity rises

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A new reporting tool built specifically for obstetrics and maternal-fetal medicine has launched, aimed at teams managing increasingly complex pregnancies with limited time and resources.

Trice Imaging has released Trice Workspace Reporting, which connects imaging, reporting and longitudinal patient data in a single workflow to support faster clinical decision making.

Birth rates are falling worldwide, but pregnancies are getting more complicated. Advanced maternal age, IVF-assisted pregnancies, rising obesity rates and a higher prevalence of hypertension and diabetes mean more cases now require specialist monitoring, advanced imaging and multidisciplinary care.

At the same time, clinical teams are stretched and facing growing administrative demands.

Trice Workspace Reporting brings together customisable reporting, dynamic pregnancy dating and longitudinal patient history with an AI-ready, EHR-interoperable infrastructure, all inside the company’s Tricefy image management platform.

The company says it aims to accelerate standardised and synchronised report turnaround, support timely clinical decisions and improve operational efficiency for fetal medicine services.

“Maternal fetal medicine teams are managing increasingly complex pregnancies while being asked to do more with limited time and resources,” said Mark A. Samii, chief revenue officer at Trice Imaging.

“Trice Workspace Reporting is designed to remove unnecessary friction from reporting by creating a structured digital foundation that supports today’s need for connected clinical workflows.

“It also provides a digital foundation as practices prepare for tomorrow and the evolution of AI-enabled fetal assessment, anomaly detection and outcome prediction technologies.”

Trice Imaging describes its mission as transforming the women’s health journey by connecting physicians, patients and healthcare systems. From independent practices to large hospital ecosystems, it aims to reach the entire women’s health continuum, spanning IVF and reproductive health, maternal-fetal medicine and OB/GYN, and onwards to lifelong women’s health.

For more than 17 years the firm has worked on cloud-based storage, retrieval, display, organisation and exchange of ultrasound medical images and associated information across health environments.

Its wider platform now extends to dynamic clinical reporting, AI-driven workflow optimisation, data analytics and secure patient engagement.

Trice Imaging holds regulatory and data protection clearances in 40 countries. It has offices in Miami and Stockholm, alongside a growing network of global distributors.

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