For decades, hospitals have relied on outdated electronic fetal heart rate monitoring during labor. This technology is often difficult to interpret, leading to guesswork and false alarms when doctors try to determine whether a fetus is receiving adequate oxygen. Relying on this inaccurate technique makes it challenging for clinical teams to confidently make timely interventions during critical episodes of delivery.
To bridge this crucial gap, a Carnegie Mellon University-led team secured a large ARPA-H grant to develop a modern, wearable system that accurately detects fetal hypoxia and its root causes. Central to this ambitious project is Suntra MedTech Solutions, an embedded technical partner specializing in complex medical device engineering. Today, we are speaking with Adam Jacobs, CTO of Suntra MedTech Solutions, to discuss his company’s role in this groundbreaking initiative, the engineering hurdles of bringing advanced sensors to the delivery room, and the future of obstetric care.
Q: Suntra MedTech Solutions is part of a nine-institution team that recently received an award of up to $39.3 million from ARPA-H. Can you tell us how this collaboration came together and what specific role Suntra plays in the project?
Adam Jacobs, CTO: Suntra has worked closely with CMU for nearly 10 years on a fetal hypoxia monitoring project. We’ve learned how to work closely together, searching for methods, models, techniques, and new insights to crack an unsolved problem. As a trusted collaborator, when CMU decided to pursue the ARPA-H initiative to improve obstetric care during childbirth, they asked us to join the team as the integrator, merging numerous sensing technologies being developed in research labs and creating a coherent medical device suitable for use during childbirth.
Q: The current standard for monitoring fetal distress relies on decades-old electronic fetal heart rate technology. Why is this legacy system so difficult for clinicians to interpret during active labor?
Adam Jacobs, CTO: The idea behind fetal heart rate monitoring is that the fetal heart rate pattern indicates when the fetus is in distress. When a contraction occurs, the heart rate changes, and the recovery afterward was thought to be a proxy for deoxygenation. And while it does indicate times when serious issues could lead to hypoxia, it also indicates many non-problematic events. Therefore, obstetricians are making conservative decisions to avoid potential fetal brain and other damage, not to mention legal litigation. The result is that most outcomes indicated by fetal heart rate monitoring include unnecessary cesarean sections, and there is no indication of what might be the potential root cause, such as occlusion in the umbilical cord, inadequate placental blood perfusion, or other root causes. Knowing the underlying problem would help determine which corrective intervention to try.
Q: Developing a noninvasive, multi-sensor platform for a fast-paced delivery room sounds incredibly complex. What are the primary engineering hurdles your team faces in making these sensors both sensitive and reliable over long periods of labor?
Adam Jacobs, CTO: The reason ARPA-H is funding this initiative is because there are many unsolved parts of this puzzle. The first issue is reliably detecting something that indicates the fetus is in danger. The fundamental problem arises when fetal blood pH becomes more acidic. This is easy to detect when a blood sample can be collected; however, there is no known non-invasive method of doing so, and it can change at any time. This leads to measuring proxies that indicate there’s an oxygenation problem and its root cause. Since that may include the fetus, maternal uterus, placenta, and systemic responses, sensors to measure them are being developed. The challenges include reliably sensing very small signals and separating signals relevant to the many tissue layers with different properties being measured.
As for usability, to be widely accepted, it needs to be easy to place on the mother, comfortable to wear for extended periods, and not interfere with the physically and emotionally challenging experience of childbirth. All this has to happen while taking numerous sensitive measurements across a large area, with the mother free to move around.
At Suntra, we have a proclivity for designing challenging medical devices, and personally, these challenges are interesting and motivating.
Q: The new wearable system pairs multiple sensors with AI models to distinguish true distress from false alarms. How is Suntra approaching the systems integration required to ensure these models provide care teams with actionable, reliable information?
Adam Jacobs, CTO: For machine learning to work reliably, it is critical that model inputs are both accurate and repeatable in ways that are not obvious. The interactions between the hardware, physiology, features being detected, and the model are commonly underappreciated. Suntra is working with the sensor developers to understand requirements, techniques, and designs that lead to the signals providing needed information to the model in a way that improves the sensitivity and specificity of the results. Some examples include temporal synchronization between sensors, calibration methodologies, designing features that are stable over time and across devices, and building hardware with manufacturing control points that improve repeatability.
Q: You noted earlier that research like this “lives or dies on whether it survives contact with a real labor and delivery floor.” How does Suntra ensure that scientifically sound concepts translate into dependable, FDA-regulated devices that clinicians can easily use?
Adam Jacobs, CTO: Suntra engages early in the process of defining marketing and system requirements, collaborating with clinicians, usability experts, our clients, and others to balance diverse needs. I like to say that decisions are informed by priorities; as such, understanding different perspectives is key to balancing those priorities. Medical devices need to accommodate many different and sometimes contradictory perspectives: a medical device company wants to produce a market winner while making profits, the FDA ensures devices are safe and effective, patients want to be cured with a minimum of distress, clinicians want to provide the best care as rapidly as possible, hospitals want to be efficient and profitable, insurance companies and medicare want to reduce costs and have improved outcomes, and manufactures want the device to be easy and inexpensive to produce. That’s a lot to balance, and missing just one of them can lead to project failure.
The thing I love about working at Suntra is that over many years in the field, we’ve worked on hundreds of projects and been exposed to thousands. This provides a perspective that many with a more confined scope don’t have the opportunity to develop. As such, we can guide partners on what works and what doesn’t, uncover project weaknesses and gaps, develop solutions that reduce project and technical risk, and improve the probability of achieving a successful project outcome.
Q: Suntra brings four core disciplines to this program, including integrating security and patient-data protection from day one. Why is this proactive approach essential for the next generation of connected medical devices?
Cybersecurity and ensuring patient confidentiality are mandated by regulatory agencies around the globe. Suntra has been building these into our devices for years and has mature processes to achieve this at every stage of development, including post-deployment field monitoring.
Adam Jacobs, CTO: The development of a reliable real-time fetal distress monitoring system will represent a meaningful leap forward for obstetric care. As our conversation highlighted, transitioning from hard-to-interpret legacy equipment to a smart, AI-driven wearable requires solving significant scientific and engineering challenges. By integrating repeatable sensor streams, intelligent processing, and practical clinical usability, this initiative promises to replace delivery room guesswork with actionable, life-saving insights.
Moving forward, the modernization of maternal and fetal care will depend heavily on robust technical partnerships capable of navigating complex engineering and strict regulatory pathways. Projects like the ARPA-H MOCS program underscore the critical need to bring sophisticated technology safely into the clinical environment. With organizations like Suntra MedTech Solutions closing the gap between scientific innovation and manufacturable reality, the future of obstetric care is moving towards safer, smarter, and more reliable maternal health.
To learn more, visit https://suntramedtech.com/
Kate Arnold, MD, MBA: https://arpa-h.gov/about/people/kate-arnold
Program Page: https://arpa-h.gov/explore-funding/programs/mocs
Agency website: https://arpah.gov/