Development of a Novel Fetal Heart Rate Monitor for Twin Pregnancies; What's All The "FUS" About? (Disparities in Focused Ultrasound (FUS) Treatment)

Development of a Novel Fetal Heart Rate Monitor for Multiple Gestations:
Twin births account for 98% of all multiple gestation births in the US, and within that percentage, infant mortality is 4 times higher in twin births than in single births. There are many factors that result in this statistic but a major issue is the lack of accurate and efficient monitoring devices for multiple gestation births. When two fetal hearts share the same transducer sample volume, it creates inaccuracies and inconsistencies in reading done with the current standard, Doppler Ultrasounds. As a result, our Biomedical Engineering (BME) Capstone project aimed to develop a novel fetal heart rate (fHR) monitor for multiple gestation births. We sought to develop a triangulation algorithm capable of detecting two unique fetal heart rates in 3D space. This was achieved by first developing a phantom hydrogel system with 2 speakers mimicking the fetal heart rates in a womb. The signal data was then collected using piezoelectrics and a circuit board with Arduino, before the fHR signals were processed and differentiated using Fast Fourier Transform (FFT) with a bandpass filter and Time Difference of Arrival (TDoA) based Gaussian Mixture Model (GMM) clustering. This system successfully differentiated the two different fHR with low error, however the estimation of their respective positioning still needs further refinement in future work. Additionally, in order to encapsulate all multiple gestation births, future work could expand the hydrogel phantom system in order to model multiple gestations beyond twins, the movement of twins, and continue to enhance the accuracy of fHR estimation, and ultimately design and develop a wearable device.

What’s All the “FUS” About? (Disparities in Focused Ultrasound (FUS) Treatment):
FUS is a non-invasive therapeutic technology that leverages HIFU to treat a range of diseases and disorders by using sound waves to destroy tissue within the body without incisions or radiation. While FUS treatment is an effective, non-invasive method of treating a plethora of diseases and disorders, there are prevalent disparities within the administration and availability of FUS treatment. The STS frameworks, Actor Network Theory (ANT) and feminist critique are applied to research these disparities to address the foundational issues that these disparities stem from. While there are many categories of disparities within FUS treatment, the most prevalent ones are gender disparities and racial disparities. In order to illuminate these disparities and the reasons they exist in modern medicine, interviews and data from the Focused Ultrasound Foundation, along with research and information gathered from case studies on uterine fibroids, essential tremor, and Parkinson’s Disease were analyzed. It was concluded that these disparities stem from three main systematic issues: the incongruity between the perceived need for FUS treatment and the actual need by patients; socioeconomic barriers; and the bias of healthcare professionals and bias in medical research and approval. This trickles down to result in a lack of diversity within medical research data as well as in enrollment in FUS treatment clinical trials. Without conclusive research and evidence to support that FUS treatment is the best option to treat diseases and disorders, health insurance companies will choose the safer option and be less likely to cover novel FUS treatment. Ideally, policy changes would have the greatest impact, but to reach that point this issue needs to be more commonly discussed. As a society, the “FUS” should strive to bring light to the disparities that need to be addressed because lives are at stake.

Synthesis:
Biomedical innovation is constantly evolving and advancing in modern medicine. Both projects sought to address the critical gaps and issues within biomedical technology and healthcare equity. This was accomplished by applying our technical knowledge and conducting research and analysis in order to advance and provide more inclusive and effective solutions to the issue of inaccurate fHR monitors and Focused Ultrasound (FUS) treatment disparities, respectively. The technical project focusing on the development of a novel fHR monitor for multiple gestations aims to address the clinical need for accurate and ergonomic monitoring in high-risk twin pregnancies, seeking to differentiate the signals and determine the fetuses positions accurately. The STS project centered on the disparities in FUS treatment, highlighting the larger systemic issues that are presently limiting patient access to effective and life-saving treatment, especially those of marginalized populations. Together, these projects synthesize together to underscore the fact that engineering cannot only create technologies to solve technical problems, but they must also be considerate in identifying the disparities that may arise and evaluate the broader socio-technical systems in which this technology will be utilized. The lives of patients lay on the delicate balance of technical advancement and the critical evaluation of how such advancements and innovations are distributed and applied in actuality. Without such synthesized evaluation of biomedical technologies, these devices cannot effectively save the lives of patients.

School of Engineering and Applied Science

Bachelor of Science in Biomedical Engineering

Technical Advisors: Kristen Naegle, Natasha Sheybani

STS Advisor: Joshua Earle

Technical Team Members: Anita Kau, Anqi (Carol) Wu, Rola Suleiman