Back in April we reported about the AN24 device, an ambulatory fetal holter from the British company Monica Healthcare. Since then, the device has been making rounds around the internet, showing up at the Discovery Channel’s site, MIT’s Tech Review, and others. Because some of our editors are involved in clinical care of prenatal patients, we realized that the device is an important example to showcase how medical technology could be problematic, as it sometimes raises more questions than it answers.
Fetal heart rate monitoring is a standard clinical practice on peripartum (in labor) patients. Things like decrease in fetal heart rate, depending on its relation to contractions, or a lack of fetal heart rate variability, could be indicative of fetal distress during labor. Such heart rate abnormalities can potentially result in cesarean sections or other assistive deliveries (think forceps). That brings us to the device itself: nice idea, well implemented. But how is one supposed to read it? What if the device shows fetal bradycardia or a lack of variability? What if these abnormalities come and go in cycles? Or they happen just once? What do you do then?
Critics will point out that the device is geared towards high-risk patients. But is it ethical not to monitor healthy pregnant patients, as they also can have stillborns? What about all the false positives? They can have an enormous impact on the price of prenatal healthcare. These are some questions we had.
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