The leading cause of maternal deaths worldwide is postpartum hemorrhage (PPH). According to the World Health Organization, 14 million women experience PPH each year, resulting in 70,000 maternal deaths around the world annually. These maternal deaths are inequitably distributed globally and the burden is largely borne by those who live in low- and middle-income countries (LMIC). A majority of these deaths are preventable. Adequate and timely interventions, including uterotonics (drugs which induce uterine contraction) are the gold standard for the prevention and treatment of PPH. In low- and middle-income countries these drugs are often not available because of cost, supply chain and systematic barriers. In the absence of uterotonics, timely surgery consisting of a trio of surgical procedures is necessary to stop the bleeding and save the patient. This highlights the need for training tools for surgeons.
Dr. Esther Chin, an Obstetrician and Gynecologist from McMaster University, approached the School of Biomedical Engineering’s (SBME) Engineers in Scrubs (EiS) to work on a solution to solve this problem. Dr. Chin was connected with an EiS Team consisting of MEng and MASC students Yiting Wu, Tara Kemper, Noah Stewart, Vincent Levandier and Yonghui Chan from SBME to work on a surgical simulator to teach, learn, and practice advanced surgical procedures for managing postpartum hemorrhage.
“I got involved with EiS because I wanted exposure to medical device design projects in the biomedical space. This project gave everyone on our team this opportunity as well as the experience to create a solution for a problem that affects people at a global scale,” explains Yiting Wu.
The team developed STITCH, a low-cost, intermediate-fidelity, reusable, and portable surgical simulator to teach, learn, and practice advanced surgical procedures for managing PPH. The surgical procedures include but are not limited to B-Lynch compression suture, bilateral uterine artery ligation, and subtotal hysterectomy. It gives surgeons the opportunity to practice these techniques in a low-stakes environment before operating on a patient. STITCH is intended for use in not only LMICs but also in countries like Canada in both urban and rural settings.
The project not only helps address a global health issue, but it also gives the students involved an opportunity to gain the skills they need to launch their careers in the biotech sphere and learn how to work in a clinical environment. “This project inspired me to pursue a career in research and development in regenerative medicine,” comments Noah Stewart,” I learned a great deal about tissue mechanics and the clinical environment that I wouldn’t have had exposure to otherwise, and this invaluable opportunity will help me in the future.”
In June 2024, the team attended the Society of Obstetricians and Gynaecologists of Canada’s Annual Clinical and Scientific Conference and received positive feedback about STITCH from professionals in the field. The simulator has gained interest from residency programs in North America and international groups. The team will ship off versions of STITCH for testing by end-users in sub-Saharan Africa and Canada and continues to refine the model.