scholarly journals A Comprehensive Review of Techniques for Processing and Analyzing Fetal Heart Rate Signals

Sensors ◽  
2021 ◽  
Vol 21 (18) ◽  
pp. 6136
Author(s):  
Alfonso Maria Ponsiglione ◽  
Carlo Cosentino ◽  
Giuseppe Cesarelli ◽  
Francesco Amato ◽  
Maria Romano
Keyword(s):  
Heart Rate ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
System Development ◽  
Fetal Monitoring ◽  
Frequency Domain Analysis ◽  
Nervous System Development ◽  
Autonomous Nervous System ◽  
Fetal Wellbeing ◽  
Future Direction

The availability of standardized guidelines regarding the use of electronic fetal monitoring (EFM) in clinical practice has not effectively helped to solve the main drawbacks of fetal heart rate (FHR) surveillance methodology, which still presents inter- and intra-observer variability as well as uncertainty in the classification of unreassuring or risky FHR recordings. Given the clinical relevance of the interpretation of FHR traces as well as the role of FHR as a marker of fetal wellbeing autonomous nervous system development, many different approaches for computerized processing and analysis of FHR patterns have been proposed in the literature. The objective of this review is to describe the techniques, methodologies, and algorithms proposed in this field so far, reporting their main achievements and discussing the value they brought to the scientific and clinical community. The review explores the following two main approaches to the processing and analysis of FHR signals: traditional (or linear) methodologies, namely, time and frequency domain analysis, and less conventional (or nonlinear) techniques. In this scenario, the emerging role and the opportunities offered by Artificial Intelligence tools, representing the future direction of EFM, are also discussed with a specific focus on the use of Artificial Neural Networks, whose application to the analysis of accelerations in FHR signals is also examined in a case study conducted by the authors.

Effect of Oligohydramnios on Fetal Heart Rate Patterns during Term Labor Induction

2018 ◽  
Vol 36 (07) ◽  
pp. 715-722
Author(s):  
Janine S. Rhoades ◽  
Molly J. Stout ◽  
George A. Macones ◽  
Alison G. Cahill
Keyword(s):  
Heart Rate ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Secondary Analysis ◽  
Neonatal Morbidity ◽  
Fetal Monitoring ◽  
Secondary Outcome ◽  
Significant Difference ◽  
Electronic Fetal Monitoring ◽  
Consecutive Term

Objective To estimate the effect of oligohydramnios on fetal heart rate (FHR) patterns in patients undergoing induction of labor (IOL) at term. Study Design Secondary analysis of a prospective cohort study of consecutive term, singleton deliveries from 2010 to 2015. We included all patients who underwent IOL. Our primary outcomes were electronic fetal monitoring (EFM) characteristics in the 2 hours preceding delivery. Outcomes were compared between those induced with oligohydramnios and those induced without a diagnosis of oligohydramnios. Our secondary outcome was composite neonatal morbidity. Logistic regression was used to control for confounders. Results Of 3,787 patients who underwent IOL, 147 had a diagnosis of oligohydramnios and 3,640 were included in the no oligohydramnios group. There was no significant difference in EFM characteristics between the two groups. There was no difference in composite neonatal morbidity. In patients with oligohydramnios, EFM patterns with baseline tachycardia for 30 minutes or greater were significantly associated with composite neonatal morbidity (31.3 vs. 5.3% adjusted odds ratio 8.63, 95% confidence interval 2.18, 34.1]). Conclusion Term patients undergoing IOL with oligohydramnios had EFM patterns that did not differ from their induced peers.

scholarly journals Non-invasive Fetal Electrocardiography for Intrapartum Cardiotocography

2020 ◽  
Vol 8 ◽  
Author(s):  
Rik Vullings ◽  
Judith O. E. H. van Laar
Keyword(s):  
Heart Rate ◽  
Doppler Ultrasound ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Fetal Monitoring ◽  
Irreversible Damage ◽  
Scalp Electrode ◽  
Non Invasive ◽  
Electrophysiological Measurements ◽  
Fetal Electrocardiography

Fetal monitoring is important to diagnose complications that can occur during pregnancy. If detected timely, these complications might be resolved before they lead to irreversible damage. Current fetal monitoring mainly relies on cardiotocography, the simultaneous registration of fetal heart rate and uterine activity. Unfortunately, the technology to obtain the cardiotocogram has limitations. In current clinical practice the fetal heart rate is obtained via either an invasive scalp electrode, that poses risks and can only be applied during labor and after rupture of the fetal membranes, or via non-invasive Doppler ultrasound technology that is inaccurate and suffers from loss of signal, in particular in women with high body mass, during motion, or in preterm pregnancies. In this study, transabdominal electrophysiological measurements are exploited to provide fetal heart rate non-invasively and in a more reliable manner than Doppler ultrasound. The performance of the fetal heart rate detection is determined by comparing the fetal heart rate to that obtained with an invasive scalp electrode during intrapartum monitoring. The performance is gauged by comparing it to performances mentioned in literature on Doppler ultrasound and on two commercially-available devices that are also based on transabdominal fetal electrocardiography.

The Factor Time in Fetal Heart Rate Monitoring and the Detection of Acidosis Using the WAS Score

2014 ◽  
Vol 218 (02) ◽  
pp. 80-86
Author(s):  
V. Roemer ◽  
R. Walden
Keyword(s):  
Heart Rate ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Oscillation Amplitude ◽  
Fetal Monitoring ◽  
Significant Loss ◽  
Fetal Heart Rate Monitoring ◽  
Mean Frequency ◽  
Ph Values ◽  
Umbilical Blood

Abstract Background: Using the naked eye evaluation of fetal heart rate (fhr) patterns remains difficult and is not complete. Computer-aided analysis of the fhr offers the opportunity to analyze fhr patterns completely and to detect all changes due to hypoxia and acidosis. It was the goal of this study to analyze the factor time in fetal monitoring and to evaluate the association between the fhr and the actual pH values in arterial umbilical blood. Methods: During a period of 11 years the FHR signals (i. e., the R-R interval of the F-ECG) of 646 fetuses were recorded with a CTG and simultaneously by a computer. The computer files were analyzed thereafter, i. e., the results did not influence our clinical management. To enter the study, all fetuses must have been delivered by the vaginal route – in consequence without a significant loss of fhr signals. During forceps and/or vacuum deliveries recordings were continued. If necessary a new electrode was inserted. In this study recordings of fetuses with chorioamnionitis, tracings of malformed neonates and tracings shorter than 30 min were excluded. Thus 484 recordings were left. We used our own computer programs written in MATLAB (USA). 3 parameters were determined electronically: 1) the mean fetal frequency [fhf, (bpm)], 2) the number of turning points (N/min) in the fhr, which we called ‘microfluctuation’ (micro) and 3) the oscillation amplitude, oamp (bpm). Measurements of the acid-base variables from arterial (UA) and venous (UV) blood were performed using RADIOMETER equipment (ABL500) and trained personnel. However, only the actual pHUA values were used in this study. To detect the influence of hypoxia and acidosis, all 484 cases were separated into 7 groups according to the actual pHUA value: 55 fetuses lying in a small non-acidotic “pH-window” (pHUA=7.290–7.310, mean=7.300±0.008) were used as ‘controls’. Results: In humans fhf, micro and the oamp behave differently during the last 30 min of delivery and with different fetal pHUA values: micro is early (at 0 min) decreased with fetal acidemia and is steadily deceasing (68–40 N/min) during vaginal delivery; the oamp – mainly due to decelerations – is increased from 35 up to 70 bpm during the last 30 min. Hypoxia and acidosis increase the amplitude and duration of decelerations; finally fhf shows only an insignificant reaction to acidemia but is decreased (from 135 to 110 bpm) overall with the course of time. Therefore the 3 characteristics of the fhr might be ranged according to their decreasing sensitivity to acidemia as follows: 1) fetal microfluctuation, 2) oscillation amplitude and 3) mean frequency. The 3 components of the fhr were used to invent and apply a score named the WAS score. This score increases the association between the actual pHUA values and the activity of the fetal heart. The 3 variables of the fhr mentioned above were rated differently; the 3 factors necessary to achieve this were computed electronically using an optimization program. The result is the WAS score: WAS=mean [frq*ff(vj) * micro*fm (vj)/oamp*fa(vj)]j=1,30. Using the last 30 min of delivery the correlation coefficient r of this score with pHUA reaches 0.645, P<< 0.001. The regression is linear in our 484 cases. Conclusions: Microfluctuation is the most sensible variable of the fetal heart followed by the oscillation amplitude and mean frequency. The WAS score offers the best correlation with the actual pH values measured in arterial umbilical blood.

scholarly journals Effects of Classical Music, Natural and Murottal Music on Fetal Well-Being

2020 ◽  
Vol 4 (7) ◽  
pp. 222-225
Author(s):  
Rahayu ` Sumaningsih ◽  
Teta Puji Rahayu ◽  
Budi Joko Santosa
Keyword(s):  
Heart Rate ◽  
Fetal Heart Rate ◽  
Classical Music ◽  
Fetal Heart ◽  
Well Being ◽  
Mean Values ◽  
Sense Of Security ◽  
Before And After ◽  
Independent Variable ◽  
Fetal Wellbeing

Music affects to human psychology, provides a sense of security, comfort and fun. Classical, natural and murottal music has a tone, rhythm, speed, gentle meter capable of stimulating alpha waves, calmness, and relaxation, beneficial to the well-being of the fetus. The purpose of this study is to describe classical, natural and murotal music on fetal well-being. This Quasi-Experiment Research with pretest-posttest design. A sample of 40 individuals was divided into 4 groups of mothers. The independent variable is classical music, natural, murotal and without music. The dependent variable is fetal well-being. The mean values before and after the intervention naturally were calculated. The results of fetal well-being based on the fetal heart rate of the classical music group before treatment there were 10% of fetuses experiencing mild aspysia after treatment of the fetus experiencing 0% aspysia. Natural and Murottal Music Group before and after treatment 100% normal fetal heart rate, group without music, before and after treatment 50% of fetuses experience Mild Aspysia. Fetal wellbeing results are based on Apgar Score, the Classical Music group after listening to classical music 10% experienced mild Aspysia. Natural Music Group and Murottal after listening to natural music and murottal 100% of babies under normal circumstances. The group without music after birth 50% of babies experience mild Aspysia. Conclusion, classical music overcomes mild asphyxia based on fetal heart rate, natural and murrotal music effectively maintains fetal well-being until birth. Keywords: classical music; natural music; murottal; fetal well-being

FETAL HEART RATE VARIABILITY ANALYSIS FROM PHONOCARDIOGRAPHIC RECORDINGS

2011 ◽  
Vol 11 (05) ◽  
pp. 1315-1331 ◽  
Author(s):  
VIJAY S. CHOURASIA ◽  
ANIL KUMAR TIWARI
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Health Status ◽  
Fetal Heart Rate ◽  
Heart Sound ◽  
Fetal Heart ◽  
Heart Rate Variability Analysis ◽  
Nonlinear Features ◽  
Fetal Heart Rate Variability ◽  
Fetal Wellbeing

This paper presents an algorithm for classification of fetal health status using fetal heart rate variability (fHRV) analysis through phonocardiography. First, the fetal heart sound signals are acquired from the maternal abdominal surface using a specially developed Bluetooth-based wireless data recording system. Then, fetal heart rate (FHR) traces are derived from these signals. Ten numbers of linear and nonlinear features are extracted from each FHR trace. Finally, the multilayer perceptron (MLP) neural network is used to classify the health status of the fetus. Results show very promising performance toward the prediction of fetal wellbeing on the set of collected fetal heart sound signals. Finally, this work is likely to lead to an automatic screening device with additional potential of predicting fetal wellbeing.

A Handbook of Pre-natal Paediatrics for Obstetricians and Paediatricians, edited by Gifford F. Batstone, M.B., B.S., Alastair W. Blair, M.B., Ch.B., M.R.C.P.E., D.C.H., and Jack M. Slater, M.B., Ch.B., M.R.C.O.G. Philadelphia: J. B. Lippincott, 1971, 225 pp., $10.00

PEDIATRICS ◽  
1972 ◽  
Vol 50 (5) ◽  
pp. 835-835
Author(s):  
John C. Hobbins
Keyword(s):  
Heart Rate ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Fetal Monitoring ◽  
Pertinent Information

The British authors have chosen to call this a "handbook." It may be a handbook in size but not in content. It contains more pertinent information relating to the expanding field of perinatology than most of the bulkier texts on my shelf. Although detail and filigree have been sacrificed, the book is far from dry. In the early chapters the reader is given a concise account of fetal monitoring by interpretation of continuous fetal heart rate patterns and information obtained from scalp sampling.

scholarly journals Automated Detection of Fetal Movements Based on Baseline Calculation and Fetal Heart Rate Accelerations

2018 ◽  
Vol 12 (9) ◽  
pp. 173
Author(s):  
Mei-Jia Huang ◽  
Hui-Jin Wang
Keyword(s):  
Heart Rate ◽  
Error Detection ◽  
Fetal Heart Rate ◽  
Electronic Monitoring ◽  
Fetal Heart ◽  
Threshold Value ◽  
Fetal Movement ◽  
Important Indicator ◽  
Fetal Movements ◽  
Fetal Wellbeing

Fetal electronic monitoring is extensive and important in obstetrics. Although fetal movement is ususally used as an important indicator for quantifying fetal wellbeing, non-invasive and long-term monitoring of fetal movement remains challenging. The object of this study is to develop an algorithm for automatic detection of the fetal movements based on the analysis of Doppler ultrasound signals. In order to detect fetal movements automatically, a two-step process was proposed to track fetal movement. In Step 1, to suppress the problem of error detection, we calculated the baseline of the fetal movement signals from actography to extract new signals. In step2, we recalculated the threshold value of fetal movement detection by utilizing the information of fetal heart rate (FHR) acceleration to produced adaptive threshold values. The results showed that the union of results detected by the proposed method from actography and tocography achieved an encouraging performance with highest sensitivity and acceptable positive predictive value (PPV).

scholarly journals Use of Continuous Electronic Fetal Monitoring in a Preterm Fetus: Clinical Dilemmas and Recommendations for Practice

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Karolina Afors ◽  
Edwin Chandraharan
Keyword(s):  
Heart Rate ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Scientific Evidence ◽  
Preterm Births ◽  
Fetal Monitoring ◽  
National Guidelines ◽  
Physiological Control ◽  
Electronic Fetal Monitoring ◽  
Continuous Electronic Fetal Monitoring

The aim of intrapartum continuous electronic fetal monitoring using a cardiotocograph (CTG) is to identify a fetus exposed to intrapartum hypoxic insults so that timely and appropriate action could be instituted to improve perinatal outcome. Features observed on a CTG trace reflect the functioning of somatic and autonomic nervous systems and the fetal response to hypoxic or mechanical insults during labour. Although, National Guidelines on electronic fetal monitoring exist for term fetuses, there is paucity of recommendations based on scientific evidence for monitoring preterm fetuses during labour. Lack of evidence-based recommendations may pose a clinical dilemma as preterm births account for nearly 8% (1 in 13) live births in England and Wales. 93% of these preterm births occur after 28 weeks, 6% between 22–27 weeks, and 1% before 22 weeks. Physiological control of fetal heart rate and the resultant features observed on the CTG trace differs in the preterm fetus as compared to a fetus at term making interpretation difficult. This review describes the features of normal fetal heart rate patterns at different gestations and the physiological responses of a preterm fetus compared to a fetus at term. We have proposed an algorithm “ACUTE” to aid management.

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