DelivAR Angel

DelivAR Angel - MIT Reality Hack 2024 (Group-22)

Background Information

The birth of a newborn provides joy not only to the parents but also to the entire family and nation as a whole. However, the potential mortality of the mother and/or infant throughout the process of childbirth could bring feelings contrary to joy. Furthermore, it is worth noting that tension and dissatisfaction can be associated with the experience of loss. The child's mental well-being will be affected as they mature if their mother passes away during childbirth.

The death of a woman in pregnancy and childbirth is globally considered an individual tragedy and a human rights violation" (Miller & Belizan, 2015, p.1). Our team came from different nations, which share the same problems when discussing the number of mothers and baby mortality during labor. Our team recognized that time is an essential factor that must be considered when managing the labor process for the mother and baby.

This initiative primarily examined the labor process throughout regions of Africa. According to UNICEF (2023), the maternal death rate in Africa experienced a 34% decrease from 2000 to 2020. According to the World Health Organization (2017), the daily mortality rate for women during pregnancy and childbirth is 430. Although the maternal mortality rate in Africa has decreased, it remains an urgent issue with severe consequences for both infants and their mothers. Given the rapid development of technology, we believe that technology in medical fields continues to progress to support physicians and nurses in their responsibilities. It persistently engages in innovation to address life's challenges, substantially decreasing maternal mortality rates.

The primary factor contributing to a higher mortality rate is the lack of advanced technologies to assist both the mother and baby during the labor and delivery process. Specifically when it takes place in remote areas in developing countries. The predominant device utilized in Africa is a portable ultrasound device, which is used to tackle the issue of child mortality (Rao & Joseph, 2017). Nevertheless, we support the existence of additional devices that can assist in facilitating Africans' labor and delivery process. Our team believes that using augmented reality/virtual reality technology can effectively address this problem by serving as a tool for nurses and physicians to disseminate information throughout every phase of the delivery process. This program facilitates the provision of assistance by midwives, nurses, and health assistants throughout the childbirth procedure in rural regions of Africa. We are introducing "DelivAR Angel" an innovative solution designed to enhance the efficiency of midwives, nurses, and delivery helpers in managing labor at various stages, enabling them to make informed decisions that prioritize the safety of both mother and baby.

DelivAR Angel

DelivAR Angel is a user-friendly decision support system designed to assist frontline medical professionals, including midwives, nurses, and delivery assistants, efficiently manage labor at various stages. Its primary objective is to assist in making accurate decisions that prioritize the safety and well-being of both the mother and the baby. We have created a prototype consisting of four stages: pre-labor, active labor, delivery, and post-partum.

The first stage is referred to as pre-labor, including the initial 12 hours of the labor process. During this period, the midwives, nurses, or delivery assistants must fulfill three essential responsibilities. Initially, do cervical examinations to ascertain the baby's position, as well as the degree of cervical dilatation and effacement. Next, assess the physical state of the mother. The procedure involves assessing respiration, blood pressure, body temperature, and pulse rate. Additionally, this can promote walking and alterations in posture. Thirdly, administer analgesia that may involve the administration of intravenous opioids or the inhalation of nitrous oxide.

The second stage is active labor, which typically takes between 13 and 16 hours. In addition to regularly monitoring the mother's heart rate and offering psychological assistance, this period also emphasizes three primary factors. Initially, observe the perineum by employing perineal massage, applying warm or cold compresses, and utilizing perineal management strategies. This is a proactive measure taken to mitigate the occurrence of trauma. Next, monitor contractions occurring at intervals of around five to ten minutes. Next, assess cervix dilation by inserting fingers deeply to access the cervix. Furthermore, they must begin documenting the condition of both the mother and the infant.

The third phase involves the process of delivering the baby, which typically consists of a labor duration of 16-18 hours. At this level, there are three primary factors. Initially, assessing the condition of both the mother and the infant. Monitoring the woman's advancement through the phases of childbirth and detecting possible difficulties for both the mother and the baby. Next, making arrangements for the delivery. Thirdly, making arrangements for amniotomy if deemed essential to initiate labor. The labor assistants must perform amniotomy by intentionally breaking the artificial rupture of the amniotic fluid bag around the fetus.

The fourth stage is the postpartum period, which is the time immediately following childbirth. The postpartum period encompasses three tasks that must be accomplished. Initially, the baby's condition is assessed promptly after birth. Additionally, it encompasses auditory perception, bilirubin levels, and serious congenital cardiac conditions. To perform the task, use a sterile, sharp instrument like a scalpel or sturdy scissors to cut and secure the umbilical cord. Furthermore, in this stage, it is important to observe and track any vaginal discharge, which may consist of mucus, blood, or amniotic fluid.

The user group consists of midwives, nurses, and health assistants who assist women in delivering babies in remote areas with limited support. We posit that this virtual reality/augmented reality application has the potential to alleviate maternal anxiety and stress during the labor and delivery procedure.

Protoype Development

We developed this application by creating prototypes utilizing the Bezi platform. This platform offers a comprehensive 3D workflow design capability, including prototyping, greatly facilitating collaborative design with our staff. We are utilizing Bezi to create the prototype compatible with the Oculus Quest 3. Before implementing the design on the Bezi platform, we initially formulated the system requirements using the Balsamiq wireframe. This prototype features a dashboard that displays pertinent medical information for expectant mothers. Furthermore, the prototype also offers a real-time data feed of blood pressure, heart rate, and oxygen levels. This prototyping application provides a sequential list of tasks that delivery assistants must adhere to at each stage of the birth process, ensuring proper support for delivering a baby.

Lesson Learnt and Future Development

We encountered challenges throughout developing a prototype utilizing Bezi because some of our team members still needed to familiarize themselves with the Bezi platform. We also encountered challenges when executing Bezi on Snapdragon AR. Incorporating voice commands in the future to facilitate the tasks of delivery assistants throughout the birthing process is necessary. Ultimately, we have successfully finished the process of creating the prototype.

In the future, we anticipate enhancing these prototypes by incorporating other functionalities, such as postpartum monitoring for the mother and baby once they have completed labor and returned to their homes. These supplementary features can be highly beneficial in assisting mothers and mitigating postpartum stress. Additionally, we believe that this prototype can be applied to various scenarios, such as assisting health supports in managing cardiac concussions, correcting fractures, and addressing dislocated shoulders.

References:

Miller, S., & Belizán, J. M. (2015). The true cost of maternal death: individual tragedy impacts family, community and nations. Reproductive Health, 12(1). https://doi.org/10.1186/s12978-015-0046-3

Rao, P., & Joseph, D. (2017). Africa Wired: Portable ultrasound device to tackle child mortality. Africa Renewal. https://www.un.org/africarenewal/magazine/december-2016-march-2017/africa-wired-portable-ultrasound-device-tackle-child-mortality

Ritchie, H., & Mathieu, E. (2023). How many people die, and how many are born each year? Our World in Data. https://ourworldindata.org/births-and-deaths#:~:text=Population%20projections%20show%20that%20the

UNICEF. (2023). Maternal mortality rates and statistics. UNICEF DATA. https://data.unicef.org/topic/maternal-health/maternal-mortality/#:~:text=In%202020%2C%20sub%2DSaharan%20Africa