Preeclampsia is characterized by sudden high blood pressure during pregnancy. High blood pressure can put strain on the mother’s arteries and the heart, which affects how oxygen and blood is transported to the fetus. If left untreated, it can lead to the deadly condition, eclampsia.
Fortunately, early detection of the condition can help reduce the negative impacts on the mother and the fetus.
Supine Pressor Test
Researchers have recently developed the Supine Pressor Test, a method that predicts if and when a pregnant woman is expected to develop preeclampsia. Using a blood pressure cuff and accelerometer, the results are calculated by the changes in blood pressure from when a pregnant woman lays on her left and then on her back (Original study image, by Purdue University). After a woman discovers she is expected to develop preeclampsia, it is recommended that she works closely with her care team to monitor her health.
This new medical advancement allows for women to decrease the negative impacts of preeclampsia through early detection and treatment, helping them feel more control of their pregnancy.
Step 1: Record blood pressure laying on left side
Step 2: Record blood pressure laying on back
Nuora allows pregnant women to take the Supine Pressor test at home using the connected blood pressure cuff, accelerometer (purple piece) device, and belly band assistant.
If the mother is predicted to develop preeclampsia, Nuora helps connect the mother with her care team to develop a treatment plan, which involves tracking daily vitals (blood pressure, weight) and sleeping habits at home through the app.
Additional Sleep Tracker
Studies show that pregnant women should sleep on their sides to avoid restricting blood flow to the baby, a result of sleeping on their backs, which applies pressure on their major blood vessels. The accelerometer can be removed and worn on a belly band during sleep to track the woman’s sleep positions. If a woman is found to be sleeping more on her back than her sides, better sleep habits will be recommended to her to improve her sleep comfort and her baby’s health.
Supporting Smartphone App
The app connects to Nuora via bluetooth to allow for convenient data tracking, reminders, and monitoring instructions. This also connects the mother to her personal healthcare team so that they can track her health without her needing to visit the clinic, allowing her to collect data consistently without the white-coat effect (increased blood pressure due to being recorded in a medical setting versus at home).
As a result, Nuora can help women feel more prepared and in control of their health leading up to the birth of their baby. Because this device can be used at home, it can also help reduce costs and time spent at the doctor's office for many women, especially for those who live in more remote locations.
High blood pressure
Edema (Swelling due to kidney issues)
Current Treatment & Cure
Give birth (often times preterm through induced labor or C section)
Monitoring of blood pressure before giving birth
Magnesium supplements to keep the heart and blood pressure under control
Early medical research of preeclampsia helped me prioritize what data my product should collect (blood pressure and weight) and how that data can used by doctors during treatment.
Supine Pressor Test (Credit: Purdue University)
Supine Pressor Test
The Supine Pressor Test can predict if and when a pregnant woman will develop preeclampsia by calculating the changes in blood pressure of when a woman is laying on her left side, and then on her back.
As of now, this method has been solely restricted to medical research but allows for a great design opportunity to become a consumer product as this test only requires
a blood pressure cuff
and a smartphone to give instructions and collect data
Sleeping While Pregnant
When I presented the Supine Pressor Test in peer critique, I was challenged to consider how I can encourage people to monitor their pregnancy health beyond just the a one-time Supine Pressor Test, since the product may feel disposable if it’s one-time use. And if it’s one time use, it’s not able to follow the mother through her pregnancy so how could I use other elements of the Supine Pressor Test (the accelerometer and blood pressure cuff) to help further support the mother’s pregnancy?
As I researched more on blood pressure during pregnancy, I found that sleeping on your side during pregnancy can help
Help prevent stillbirth
Allow for the best blood flow to the fetus
Decrease the risk of high blood pressure and preeclampsia
Sleeping on your back later on in the pregnancy can apply pressure to a major artery, blocking blood flow to the fetus.(Credit: Expecting Science)
Currently, the only market product that helps monitor preeclampsia is your average blood pressure cuff. Current consumer blood pressure cuffs are great for monitoring one’s blood pressure at home to reduce doctor’s visits and the white coat effect.
But users can benefit from
reminders for how to prepare for an accurate reading
reminders for when to record their blood pressure
Pregnant users can additionally benefit from pregnancy-related feedback, so that they understand what their reading means for them, being pregnant, versus someone who is not pregnant. At this moment, no blood pressure cuff or any market device is meant for detecting preeclampsia, which allows for a huge design opportunity.
User Journey through Preeclampsia
Because the symptoms of preeclampsia are similar to common pregnancy symptoms (swelling, frequent urination, nausea), the condition often goes unnoticed by pregnant women until they return to the clinic for a blood pressure test.
After a diagnosis, the stress of needing frequent doctor’s visits and worries about harm to the fetus can contribute to an increased blood pressure.
Rachel, 27 year old Future Mom
Medical Background: 17 weeks pregnant with her first baby
Current Care/ Pain Points: Visits her prenatal doctor, who is 40 minutes away, monthly
Goals: To have a healthy pregnancy and a healthy baby
Much like any other pregnant woman, Rachel, my persona shaped by online stories of preeclampsia survivors, has a goal to have a healthy pregnancy and a healthy baby but her long commute time to her doctor makes visits inconvenient.
No pregnancy-related feedback
Current blood pressure cuffs don't inform users of their measurements in relation to their pregnancies.
Difficult to detect preeclampsia
Symptoms often go unnoticed as they are similar to common pregnancy symptoms (nausea, swelling, headaches)
Need for regular monitoring
Blood pressure needs to be monitored everyday to track the development of preeclampsia.
Create strong patient-healthcare team relationships to improve quality of care.
Help users become aware of health issues early on so they can seek treatment as soon as possible and reduce the impacts of preeclampsia
Help women take control of their pregnancy and their health so they feel powerful in overcoming preeclampsia
How might we design a product that allows pregnant women to monitor their daily health in relation to preeclampsia so that they can treat it early on and reduce the negative impacts of the condition?
Ideation & Prototyping
Early sketches explored how I could incorporate the elements of a Supine Pressor Test into common pregnancy products and therefore, help pregnant women incorporate this product more naturally into their routine. A maternity belly band (used to help pregnant women cover their bellies when wearing clothes as their belly grows) became my top choice as it could hold the accelerometer during the SP test, while also be worn as a daily accessory when not taking the test.
To better imagine the user experience of these concepts, I created simple foam prototypes to explore its interactions with the body, sizing, and how these multiple components would fit together within a system.
After deciding that my product will consist of a blood pressure cuff and a bellyband accelerometer, I explored many form studies, including ideas that allowed the accelerometer to dock into the cuff for storage and charging functions.
A prototype was created using a 3D printer and fabric to test the docking feature, size, and overall usability.
Provides pregnancy-related feedback
Pregnant users can understand their health measurements in relation to not only their bodies, but also their pregnancy and their baby's development
Detects and monitors preeclampsia through new medical advancements
Utilizes the Supine Pressor Test and sleep research findings to best provide care and information for the user
Encourages regular and accurate blood pressure monitoring
Reminds the user to monitor their blood pressure daily, especially if at risk for preeclampsia. Also reminds users on how to accurately take a test (avoid caffeine, feet flat on the ground)
User Journey with Nuora
Without Nuora, a preeclamptic mother's journey is filled with stress. But with Nuora, my goal is to help women work out a treatment plan with their care team before preeclampsia develops so that they feel prepared when the condition develops and hopefully, gain a better sense of control over their health.
Smartphone App Features
The home page allows the mother to track her baby's development, which as a result, motivates the mother to continue keeping up with her health.
The app also
guides the mother through the supine pressor test and results
allows her to set reminders for blood pressure monitoring
allows her to view her sleeping habits
Nuora In Use
Reflection & Takeaways
Design & Healthcare
Through this project, it was rewarding to learn that designers have the power to help reduce health costs for patients and make healthcare more accessible to people, especially for those in remote areas. It was fascinating to learn about the new technologies and methods researchers are developing to address preeclampsia and how designers can use these medical advancements to design user-friendly products.
With more time, I'd like to add to Nuora a product that can also track edema (swelling) as that is another key symptom of preeclampsia. For this 10 week timeline, I focused primarily on designing the Supine Pressor Test to be user-friendly and easily integrated in a pregnant person's routine.
Special thanks to
Josh, Aaron, Nick, & Carson from Tactile
Professor Jason Germany
my talented design peers