January 23, 2022
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Heart rate of unborn child captured more accurately with new technology

By on March 23, 2021 0


The heart rate of an unborn child says a lot about a child’s development, such as congenital heart defects. This is why heart rate is measured regularly, both during pregnancy and during childbirth. Today, obstetricians and gynecologists use ultrasound technology to do this. An ultrasound transducer is placed on the mother’s abdomen and sends sound frequencies to the baby. The sound bounces off the beating heart. The movement of the heart changes the frequency of the reflected sound. This is how the heart rate can be measured. The problem with this technology, however, is that sound bounces off other tissues in the abdomen as well. If the baby or the mother is moving, the heart rate often cannot be measured correctly. As a result, this heart rate measurement is only accurate about seventy percent of the time.

At the beginning of this century, a young gynecologist from the Dutch Máxima Medical Center, Dr. Guide Oei, exposed the problem to Eindhoven University of Technology (Mar). This prompted Rik vullings research new measurement methods as part of their end-of-studies research. He found that the electrodes on the abdomen give a much more accurate picture of the heartbeat: “Our nervous system sends electrical stimuli to the muscles that make them move. The heart, with a relatively large amount of muscle tissue, has a very recognizable electrical pattern. In principle, therefore, it is possible to make this signal visible, which is hidden among all kinds of other signals and noises. It’s not easy, but we managed to do it at Nemo Healthcare, ”says Vullings.

Co-founder Rik Vullings (seated) and CEO Michiel Manuel © Nemo Healthcare

Cardiogram

The electrodes are affixed to the abdomen like stickers and thus are able to measure the baby’s heart rate for a long time. “This technology also makes it possible to do a cardiogram. This allows obstetricians and gynecologists to extract even more information, ”continues Vullings. “This was not possible before during pregnancy”, adds CEO Michiel Manuel.

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The technology is very promising, which is why Vullings and his thesis supervisor Chris Peters – who has also researched this technology in the past – decided to put it to use. They received two valuation grants through the Dutch Research Council (NWO).

That was the starting shot for the spin-off Nemo Health. A first round of investment was followed by two loans of Luminous movement create a working prototype and examine an initial business case. “We were able to set up the science side of the business properly, but for the business side, we started looking for someone who could help us in this area,” says Vullings. “Bas Lemmens then quit his job (and the security that came with it) to join Nemo Healthcare as its first CEO.”

The company has experienced considerable development in recent years, both scientifically and commercially. Michiel Manuel, who has long been in charge of the development, introduction and sales of medical systems at Philips, has been CEO of Nemo Healthcare since October 2017. Since then, Nemo Healthcare equipment is now in use at four universities. hospitals across Europe.

Clear graphics

The device measures three things: the baby’s heart activity, the mother’s heart activity, and the activity of contractions. This information is displayed simultaneously in a graph on the screen of the gynecologist or midwife. They monitor the baby’s development and determine their actions based on this information. With the technology of Nemo Healthcare, it is more precise and more comfortable than using the old methods. In one in three cases where an abnormal heart rhythm is detected, there is actually something wrong with the child. “One of the things we want to do with our device is to avoid unnecessary interventions,” says Vullings.

Childbirth follow-up

Information about the heart rate of mother and child is also very important during childbirth. The main risk during childbirth is the lack of oxygen for the baby, for example because the umbilical cord is pinched or because it is wrapped around the baby’s neck. This can also be monitored through the heart rate. If the child’s condition deteriorates rapidly, the gynecologist or midwife may decide that a cesarean section should be performed.

Another way to measure a baby’s heart rate during childbirth is by using the fetal scalp electrode (FSE): a small screw on the end of a catheter that is inserted into the baby’s head. “The fetal scalp electrode is not a pleasant method,” says Manuel. “But with existing technology, this is the only way to measure babies correctly during childbirth.” Nemo Healthcare wants to change that. This is because the new technology is just as precise as the current invasive fetal scalp electrode.

a long way to go

In the meantime, it is clear that Nemo Healthcare’s technology is going to have a major impact on the advancement of obstetrics. Even if the road to new equipment has been long and not always easy. Manuel: “As a start-up, you always have more ideas for your development than there is money. He explains that between 2010 and 2015, the company managed to make progress with small investments and loans from Bright Move and others, but after that it stalled. The money ran out and the payment of wages was delayed.

In early 2016, a grant from the European Union (the Horizon 2020 program) was approved and around four private actors invested in Nemo Healthcare. Then all of a sudden, the company has 7 million euros and the development of the product accelerates. At the end of 2018, the first version of the product was certified and made available to selected hospitals.

The funding came at exactly the right time, but everything could have turned out very differently. There had been 1,100 applications for grants provided by the Horizon 2020 program. In the end, Nemo Healthcare was able to secure the largest grant amount. Attracting upstream investors before a product has had the chance to prove itself on the market is not easy either: “For the stages from concept to first product, there are often pockets of financing. But at some point, investors have to step in with large sums of money, ”says Frank van de Ven, business developer at Bright Move and TU / e.

The luck factor

Since the development and validation of medical systems is carried out very meticulously, these procedures are often time consuming. For example, companies need the resources to get their product through extensive clinical testing and approval. This allows them to prove that the technology works and is safe. But many investors want to see the evidence before they decide to invest.

“This phase is also called Death Valley in business development. Van de Ven goes on to say, “To get through this you have to have a good product and a good story, of course. Even if sometimes it’s also about being in the right place at the right time, in other words a little luck. Manuel adds: “We have a product that a lot of people like, it has everything to do with the beginning of life, with healthy pregnancies and children. Everyone encounters this in life. It makes it easier to get people excited. “

Detect heart defects

In 2021, Nemo Healthcare plans to sell the equipment to various hospitals, especially in Europe. “Then I expect that by the end of 2021 we will be in the dark for the first time,” Manuel says. Besides the commercial side, the search for new applications for the technology is also continuing. For example, in collaboration with TU / e, the spin-off is studying how the equipment can contribute to better detection of congenital heart defects during the 20-week ultrasound.

Vullings explains that about forty percent of heart defects go undetected by this ultrasound. While in some cases children with heart defects have a much better chance of survival if the defect is caught in time. “Administering certain medications or having surgery immediately after childbirth can save the baby in some cases,” continues Vullings. Since Nemo Healthcare’s equipment can provide a detailed cardiogram, Vullings believes it will also help reduce the percentage of children in whom a heart defect is not detected before birth.

Nemo’s first device, after nearly 20 years of research, product development and marketing, is poised for a huge commercial breakthrough. Manuel and Vullings have full confidence in this. Manuel: “Especially in view of the enthusiastic reception from the very first users.

The spin-off of the spin-off series is an initiative of Federation 4TU and the origins of innovation. Here you can read stories behind the spin-offs of the four Dutch technical universities and the Netherlands Organization for Applied Scientific Research (TNO). In spinoff companies, science and entrepreneurship come together to bring new technology to market. They are a driving force for innovation in the Netherlands.

Read the other articles in this series here



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