Q&A: the challenge of foetal monitoring with Professor Barrie Hayes-Gill

I actually never set out to work in this area. I'm an electrical engineer and worked in industry for many years for large semiconductor companies. But when my family wanted to move back to Nottingham, I went to work in academia.

Within a month of starting a role at Nottingham University, my wife — who had just given birth to our second child — was diagnosed with an aggressive cancer called adenocarcinoma. Tragically, she died after 12 months. It was horrendous but the university was fantastic, and told me to look after my family and put my research on hold for a bit. When I returned to work, I was understandably more interested in healthcare research and how electronics could help.

Nearly two years later, a colleague also died of cancer. He had been doing work on foetal monitoring. I went to see him in the hospital and he asked me to carry the work on with other colleagues. Two significant deaths in my life found me in this field.

Foetal and maternal heart rate confusion is a big issue. Obviously, you get an electrocardiogram (ECG) reading on your chest. But you can also get a signal (albeit a much smaller one) if you measure down at the tummy from the maternal pulsing blood supply and the ECG itself. Clearly, this can be a problem with a pregnant woman when both her heart rate and foetal heart rate are present in the same place.

The standard Doppler ultrasound monitor has to be repositioned frequently to ensure it’s pointing at the foetal heart. Otherwise, you can get 30-40 minutes of the wrong heart rate. You can think everything's fine and then find the foetal heart rate has dropped down, putting the baby at risk and posing severe morbidity issues such as cerebral palsy.

So we developed an electrical method to detect both the maternal and foetal ECG. These signals have distinct signatures allowing separation with minimal confusion. We deployed three detection channels across the abdomen instead of one. That way, if the baby was lying to the left or right, we could get still get good detection.

Monitoring technology can be restrictive but our device is wireless so women can move freely during labour. Further, it is unaffected by high BMI, unlike the ultrasound, so it works for women of all sizes.

We were lucky enough to win the Joint Research Councils Biosciences business plan competition in 2004 which made us more attractive to investors. We started the spin-out company Monica Healthcare in 2005. And by 2016, we had completed eight investment rounds with sales around the world. In March 2017, Monica was acquired by GE.