Globally, bleeding is one of most common reasons women die around the world in childbirth. The main reason things get so serious is that the issue is not recognised and managed quickly enough. Identifying women with dangerous bleeding can be very difficult and it is widely acknowledged that delays in spotting and starting treatment for bleeding patients contributes to death and harm. Additionally, clinicians are not able to predict haemorrhage (bleeding) from risk factors very easily. This means the focus needs to be on early recognition of a compromised patient, appropriate escalation and prompt management.

Although the NHS has sophisticated systems to spot deteriorating patients in many clinical settings, the predictive capacity of early warning systems in pregnancy is less well-evidenced and most blood pressure devices are not designed with pregnant women in mind. The CRADLE VSA device was created by UK doctors working in developing countries, in response to a severe and urgent need to spot bleeding patients in the context of very high maternal death rates. However, its simplicity and effectiveness could also have huge benefits in other healthcare settings globally, including in the NHS.

How does it work? CRADLE VSA uses a simple traffic light system to warn clinicians when a woman may be in trouble after giving birth. The lights are triggered by standard thresholds of blood pressure as well as shock index to alert health care professionals to a patients’ risk of compromise. The shock index is an innovative and simple measure. It is calculated by dividing heart rate by systolic blood pressure and it is a highly effective way of signalling that someone is in trouble and needs help.

The biggest impact of this device is expected to be on patient safety. Use of this device should reduce delays and reduce maternal death rates and morbidity. This would also lead to a reduction in length of stay for patients and faster return to daily activities and time with their newborn.

The Innovation Grant funding will be used to introduce the CRADLE VSA device into labour wards and high dependency units at Kingston Hospital and St Thomas’ Hospital. The results will be analysed using PSDA cycles and a quality improvement toolkit will be created so that the device can be used more widely if successful in these settings.

This ground-breaking device has been extensively validated. It was recognised in the PATH – Innovation Countdown 2030 award as one of the top 30 high impact global health innovations to help accelerate progress towards the United Nations Sustainable Development Goals. It also won the prestigious Newton Prize in 2017 for excellence in research and innovation.

Find out more about our work in maternity and patient safety