Written by Kim Furlow, communications program manager, Institute for Public Health
WashU Medicine Asst. Professor (cardiology and Ob/GYN), Zainab Mahmoud, MD, and Christine O’Brien, PhD, assistant professor of biomedical engineering, have a lot in common. They’re both Public Health Faculty Scholars, they both collaborate often with the Global Health Center, and they’re both integral to research teams that focus on lowering rates of maternal death. Their recent work is a collaboration with Global Health Center leadership and cardiovascular and maternal health experts in Nigeria. Their mutual ultimate goal is to improve outcomes among pregnant women in marginalized areas of the U.S. and Nigeria.
Current projects
Mahmoud says her team is working on an evidence-based intervention that uses a low dosage of aspirin to prevent preeclampsia in high-risk pregnant women. Mahmoud said the goal is to identify barriers to its adoption and develop strategies to enhance implementation.
Additionally, Mahmoud’s team is working on prevention of another high-burden issue for pregnant women in marginalized communities – hypertensive disorders. This intervention implements a comprehensive postpartum care HDP Bundle that includes patient education, BP monitoring, close follow-up, and provision of anti-hypertensives. The aim is to improve postpartum blood pressure control and reduce maternal morbidity and mortality associated with postpartum blood pressure spikes.
Collaboration toward a joint goal
Both Mahmoud and O’Brien are dedicated to improving health outcomes of high-risk pregnant women in Nigeria, where their team, the Global Health Center and cardiovascular and OB/GYN experts at the University of Abuja have joined forces to lower the historically high maternal mortality rates in the country.
“We are collaborating closely with physicians, midwives, nurses, and other health care workers in both Nigeria and the U.S. on these projects,” said Mahmoud. “Additionally, we are working with Dr. O’Brien to address the other leading cause of maternal death there — postpartum hemorrhage.”
“Ninety percent of these deaths are preventable with earlier detection and earlier treatment,” said O’Brien. “The timing of treatment is important because at early stages of blood loss, easily accessible and low-cost treatments can be effective, but at late stages, high-cost blood products and surgical interventions are required to save a patient’s life. These aren’t always available in underserved settings, including rural America.”
New device for pregnant women at risk
O’Brien is collaborating with Global Health Center colleagues Mahmoud; co-Director, Mark Huffman, MD, center Director, Victor Davila-Roman, MD, and other WashU team members, to develop a light-based wearable sensor that can be worn by patients during labor and postpartum recovery to detect early signs of postpartum hemorrhage. The device helps quantify blood loss in real-time to alert health care providers at early stages so they can facilitate timely treatment.
“Nearly a quarter of the world’s maternal deaths occur in Nigeria,” O’Brien said. “Our team is hopeful that this technology and partnership will help reduce morbidity and mortality caused by postpartum hemorrhage.”
A partnership
O’Brien, Mahmoud and team have expanded their project partnership to include expert cardiologist, Dike Ojji, MD, and obstetrician/gynecologists, Bissallah Ekele, MD and Dennis Isah, MD, from the University of Abuja Teaching Hospital in Nigeria, to identify facilitators and barriers to patients wearing the postpartum hemorrhage sensors while in the hospital. The collaborative’s findings help the team adapt the wearable sensor hardware, software, and workflow for maximum success in future pilot and expanded clinical studies.
All in all, both Mahmoud and O’Brien have said they appreciate the collaborative nature of their current projects and their relationship with the Global Health Center. O’Brien recommends this relationship building for other researchers adding, “My research has benefited enormously from my engagement with the GHC and has led to both WashU and international global health collaborations, mentorship, grant funding, manuscripts in development, and meaningful friendships.”