CRADLE: an easy, cheap way to measure blood pressure and detect pregnancy complications in rural communities

Tommy’s have collaborated with Microlife Ltd to create a simple, accurate way of measuring blood pressure anywhere in the world.

Measuring a mother’s blood pressure and pulse during pregnancy is vital to detect life-threatening conditions. Dangerously high blood pressure is a sign of pre-eclampsia, while low blood pressure and a fast pulse indicates shock from dangerous bleeding. However, these signs are often missed in areas where there isn’t enough pregnancy related care, or knowledge of how to measure blood pressure properly. This can result in deaths that can be avoided.

Tommy’s have collaborated with Microlife Ltd to create the CRADLE device, which provides an accurate and easy way to measure blood pressure and pulse. The device doesn’t need any expertise: it can be used by anyone from a community health worker to a doctor or midwife. Each device costs less than £15. CRADLE includes an early warning 'traffic light' system to tell health workers when changes in blood pressure and pulse need medical action. We have adapted the device so it can be used in places with few resources by including a micro-USB port and sealed rechargeable lithium battery pack. This means it can be charged using a standard mobile phone charger.

This year, we tested CRADLE in sub-Saharan Africa to see whether it could help detect pre-eclampsia. We are happy to report that the introduction of the device in clinics led to more women being referred from the community to hospitals with suspected pre-eclampsia. This meant that women with signs of pre-eclampsia could be observed and properly cared for.

The most recent phase of the CRADLE project, CRADLE 3, began in November 2015 to test the device over three months in Ethiopia, Zimbabwe and India. Results showed that making CRADLE part of standard pregnancy care, both in hospitals and communities, was definitely possible.

In April 2016, CRADLE 3 was expanded to 10 sites including Haiti, Uganda, Sierra Leone and Malawi. We will continue collecting data for around 2 years. We believe that this cheap, accurate, easy-to-use device will help find signs of life-threatening pregnancy conditions earlier. Doctors will then be able to care for these women, giving mother and baby the best shot at a healthy pregnancy. 

The CLIP trial

The CRADLE device is also being tested as part of the two year CLIP (community-level intervention of pre-eclampsia) trial in Mozambique, Nigeria, India and Pakistan. We hope the tool will increase the detection and care of women with pre-eclampsia. We expect data collection for this trial to finish in April 2017. 

Researchers

Professor Andrew Shennan, Mr Paul Seed, Professor Jane Sandall, Professor Lucy Chappell, Dr Hannah Nathan, Dr Nicola Vousden, Elodie Lawley, Dr Natasha Hezelgrave. Collaborators: Professor Suellen Miller, Professor David Hall, Professor Willem Steyn, Professor John Anthony, Dr Peter von Dadelszen and the PRE-EMPT team

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Funding

This study partly takes place in a Tommy's centre and is funded by Tommy's, the Bill and Melinda Gates Foundation, the Medical Research Council and the Indian Department of Biotechnology

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