HLTH 210 Lecture Notes - Lecture 21: Signal Processing, Decision Support System, Stunted Growth
7 May 2018
School
Department
Course
Professor
Health - new innovations
● IUGR (intrauterine growth restriction) screening in rural guatemala
● Guatemala has highest rates of growth stunting than its neighbors and income peers
● Growth stunting
○ Delayed mental and motor skill development
○ Mostly malnutrition - rates of chronic malnutrition >50%
○ Fixable through better decision support
● IUGR mostly malnutrition driven
○ In the department of chimaltengo - estimated to be about 70%
○ Undernutrition begins early - has an intergenerational effect
○ Start of 2nd trimester, normal fetus growth takes off and differentiates from IUGR
● Intervention location: tecpan
○ Transportation is ad hoc - back of pickup truck
○ Paquip - a “large” village were their midwives work
■ Good cell reception, has a radio tower
○ Smaller villages “near” paquip where the pregnant women live
● Current midwife practices
○ 60% of all births are attended by traditional midwives in guatemala
■ Higher for villages in this region
■ Only 1 hospital maternal bed, 40 in total for 500k ppl
○ Midwives very respected with wide range of training
■ Some gov’t registration; WHO policy
○ Equipment is random - some stethoscopes, BP cuff, ID doppler
○ Use of massage - temescal
○ Paper record keeping: very ad hoc
● NGO partner
○ Wuqu’ Kawoq - pediatric care, pregnant women in this region
■ Children in our communities suffer from the highest levels of chronic
malnutrition in the Americas - higher than haiti or bolivia
○ They built a decision support system for TBAs
■ Smart phone + ID doppler connected to speakers and oximeter to hear
fetus’ heartbeat
○ The system can tell TBA when recording is poor or if there is maternal/fetal HR
confusion
■ Key is signal quality to improve data at source!
● IUGR detection
○ ML-based signal quality classifier
■ Remove noisy data, or request re-recording
○ HMM to detect “beats”
■ Calculate HR
○ Then apply ML model to beat tachogram
■ Fetal HRV matures as fetus matures
■ ML model developed which processes the VS data and GI
○ HR not dependent on birth weight
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Iugr (intrauterine growth restriction) screening in rural guatemala. Guatemala has highest rates of growth stunting than its neighbors and income peers. Mostly malnutrition - rates of chronic malnutrition >50% In the department of chimaltengo - estimated to be about 70% Undernutrition begins early - has an intergenerational effect. Start of 2nd trimester, normal fetus growth takes off and differentiates from iugr. Transportation is ad hoc - back of pickup truck. Paquip - a large village were their midwives work. Good cell reception, has a radio tower. Smaller villages near paquip where the pregnant women live. 60% of all births are attended by traditional midwives in guatemala. Only 1 hospital maternal bed, 40 in total for 500k ppl. Midwives very respected with wide range of training. Equipment is random - some stethoscopes, bp cuff, id doppler. Wuqu" kawoq - pediatric care, pregnant women in this region.
