Barnsley Hospital NHS Foundation Trust is the first maternity unit in the UK to use the geko electrostimulation device to reduce the risk of blood clots in high-risk patients during pregnancy.
Deep Vein Thrombosis (DVT) represents the biggest cause of maternal death in the UK, with patients more likely to develop a blood clot during pregnancy and after delivery than at any other point in their lives.
The current standard of care for blood clot prevention during pregnancy are blood thinning drugs (anticoagulants), mechanical pneumatic compressive devices (IPC) or elastic stockings.
Some patients are unable to be prescribed these prophylaxis methods for a variety of reasons, including severe pre-eclampsia, where patients might need urgent delivery, or post-partum haemorrhage – leaving them without a method of blood clot prevention, presenting an unmet clinical need.
To address this, Barnsley Hospital NHS Foundation Trust carried out a pilot observational study to determine whether the geko could be suitable for blood clot prevention in high-risk pregnant patients for whom the current standard of care is not suitable.
The geko device is a small watch-sized device that sticks to the leg and increases blood flow, via painless electrical pulses, at a rate equal to 60% of walking without a patient having to move.
The study focussed on 90 patients who could not be prescribed anticoagulants or mechanical compressive devices, this represented 2% of the overall patient population. All 90 patients required the geko device during some stage of labour, and more than half were prescribed the geko device as the only method of blood clot prevention.
The study found that the device was safe and well tolerated by all 90 patients, giving this high-risk group a method of protection where other mechanical interventions and anticoagulants are unsuitable. Following this, the hospital has now adopted the geko device into its obstetrics pathway and it will be available for all high-risk pregnant patients who are unable to be prescribed alternative methods of venous thromboembolism (VTE) prevention.
Dr Mona Fawzy, consultant in obstetrics & gynaecology, Labour Ward lead and deputy obstetric lead at Barnsley Hospital, said: “Patients are at greater risk of developing a blood clot during pregnancy and after delivery, than when not pregnant, so it is essential to assess high-risk patients regularly regarding their risk of developing a blood clot to protect and keep them safe. Currently, there is a small but significant group of patients who are left without an appropriate blood clot prevention method, putting them at greater risk.
“Recognising the need to provide prophylaxis to at risk patients, we embraced the opportunity to examine the role of the geko device in the obstetrics population. Our findings show the geko device is safe and well-tolerated and can be used to protect patients until it is safe to prescribe blood thinning drugs. We are pleased to be the first NHS maternity unit able to provide a blood clot prevention strategy for all high-risk patients in our care.”
Bernard Ross, founder and CEO of Sky Medical technology, the company behind geko, added: “The willingness of Barnsley Hospital to review its unmet need, take part in a study to understand the effectiveness of the geko device and ultimately adopt this innovation is significant. This is an important step towards ensuring all at-risk patients during pregnancy have a safe method of blood clot prevention.
“DVT is the highest cause of maternal death in the developed world so it’s essential high-risk patients have access to a viable prevention method. This study demonstrates the positive impact innovative can bring to this high-risk patient population, and I applaud Dr Fawzy and Barnsley Hospital for leading the field in embracing new treatments to ensure all patients are protected – and for the generation of data that has influenced other obstetric units to follow suit in embedding the geko device into clinical practice for VTE prevention.”