Cicogna Project: Safer Pregnancies with Remote Monitoring

The result of the research and innovation project called CICOGNA is a medical device for remote monitoring of pregnant women during the final stages of pregnancy and in high-risk pregnancies. This project is based on wearable technologies and the remote transmission of collected parameters. It involved several private companies and saw the collaboration of the IRCCS San Gerardo dei Tintori Foundation, one of the public Scientific Institutes for Research, Hospitalization, and Healthcare. The hospital is the main healthcare facility for the city of Monza and hosts the Faculty of Medicine and Surgery of the University of Milan-Bicocca.

The device consists of a very lightweight, easy-to-wear belt with a series of stethoscopes that listen to the mother's abdomen. Through sound analysis, it can identify various parameters, from the heartbeat to the fetus’s movements, such as kicks and punches that cause abdominal deformation. This device does not require special assistance and ensures continuous monitoring of the fetus's health.

The idea originated from the owner of a software company that has long been working on medical management systems and middleware for the integration of biomedical devices in collaboration with healthcare institutions. In a radio interview on a program dedicated to cohesion policies in the Lombardy Region, the owner shared that a member of his family had lost a stillborn baby. Shocked by this event, he envisioned developing software capable of managing data and triggering clinical alerts, particularly in the weeks leading up to delivery and during labor, with continuous monitoring of the fetus’s health. “To signal any anomalies that could have prevented what we experienced,” he said on the radio.

The device was tested on about fifteen patients who had completed their pregnancies, as explained by Sara Ornaghi, a researcher and physician at San Gerardo di Monza. Ornaghi explains that the type of assistance is similar to the so-called “trace”, or cardiotocography, which monitors fetal heart rate, an indicator of the baby’s well-being. Currently, “this is done on a one-time basis in a hospital setting, with weekly or bi-weekly frequency,” particularly towards the end of pregnancy. “There is no continuous monitoring, and the identification of well-being is not ongoing,” Ornaghi says, highlighting “an innovative aspect connected to continuous monitoring, which allows defining and identifying the specific pattern for that baby. In case of significant anomalies, it triggers an alert. Today, instead, we rely on the mother’s perception, which only concerns possibly reduced fetal movements.”

Thanks to the Cicogna project, a subjective element (the mother’s sensations) is replaced by an objective control, crucial for describing the fetus’s and, to some extent, the mother’s health. Data collection and transmission, along with any clinical alerts, can be easily managed remotely through dedicated network-connected phones. It is a remote monitoring system that, when necessary, identifies the need for medical intervention within the hospital, thus also reducing the number of unplanned visits.

In the 2021-2022 school year, the project was monitored by the “Piume 2AU” team from the Upper Secondary School “Ernesto Breda” in Sesto San Giovanni, Milan. Their evaluation, as indicated in the Monithon Report, is as follows: “The project is innovative and functional. We believe it is a truly useful product as it allows for 24-hour monitoring of both the baby’s and the pregnant woman's vital parameters.”