High-risk pregnancies are becoming more prevalent because of the progressively higher age at which women get pregnant. Typically, they cover 20% of all pregnancies. In addition, in the Netherlands, yearly about 500 newborns are admitted in the neonatal intensive care unit because they suffer from birth asphyxia or maladjustment in the transition from intrauterine to postnatal life with difficulties in breathing and oxygenation.
During birth, the most commonly used clinical tool for fetal monitoring is the cardiotocogram (CTG). The CTG consists of the simultaneous registration of maternal uterine contractions and fetal heart rate variations. Unfortunately, clinical interpretation of the CTG is difficult since the CTG only reflects the input and output of a very complex sequence of events in the fetus, involving hemodynamics, oxygen transport, and neurohumoral feedback. We aim to enhance CTG interpretation by mathematical modelling of these underlying processes. As an important bonus in comparison to the clinical situation, the model provides predictions of fetal oxygen content, a crucial determinant of fetal welfare (Beatrijs van der Hout - van der Jagt, PhD Thesis: Germaine Jongen 2016).
While the newborn is more accessible for measurements than the foetus, still clinical decision making remains difficult. Also in this field we aim to assist in decision making by mathematical modeling of typical pathological scenarios such as apnea, alveolar collapse, patent ductus arteriosis or foramen ovale, and myocardial depression (Tamara Klopmeijer en Camile van der Heijden). The model will also be used to intelligently link sensors and actuators in a manikin of the newborn, developed as an educative training tool at the department of Industrial Design at TU/e.
Our research in the area of perinatal care is performed in close collaboration with Máxima Medical Center.