Extracting fetal heart beats from maternal abdominal recordings: Selection of the optimal principal components

This study presents a systematic comparison of different approaches to the automated selection of the principal components (PC) which optimise the detection of maternal and fetal heart beats from non-invasive maternal abdominal recordings. A public database of 75 4-channel non-invasive maternal abdominal recordings was used for training the algorithm. Four methods were developed and assessed to determine the optimal PC: (1) power spectral distribution, (2) root mean square, (3) sample entropy, and (4) QRS template. The sensitivity of the performance of the algorithm to large-amplitude noise removal (by wavelet de-noising) and maternal beat cancellation methods were also assessed. The accuracy of maternal and fetal beat detection was assessed against reference annotations and quantified using the detection accuracy score F1 [2*PPV*Se / (PPV + Se)], sensitivity (Se), and positive predictive value (PPV). The best performing implementation was assessed on a test dataset of 100 recordings and the agreement between the computed and the reference fetal heart rate (fHR) and fetal RR (fRR) time series quantified. The best performance for detecting maternal beats (F1 99.3%, Se 99.0%, PPV 99.7%) was obtained when using the QRS template method to select the optimal maternal PC and applying wavelet de-noising. The best performance for detecting fetal beats (F1 89.8%, Se 89.3%, PPV 90.5%) was obtained when the optimal fetal PC was selected using the sample entropy method and utilising a fixed-length time window for the cancellation of the maternal beats. The performance on the test dataset was 142.7 beats2/min2 for fHR and 19.9 ms for fRR, ranking respectively 14 and 17 (out of 29) when compared to the other algorithms presented at the Physionet Challenge 2013

Novel hybrid extraction systems for fetal heart rate variability monitoring based on non-invasive fetal electrocardiogram

This study focuses on the design, implementation and subsequent verification of a new type of hybrid extraction system for noninvasive fetal electrocardiogram (NI-fECG) processing. The system designed combines the advantages of individual adaptive and non-adaptive algorithms. The pilot study reviews two innovative hybrid systems called ICA-ANFIS-WT and ICA-RLS-WT. This is a combination of independent component analysis (ICA), adaptive neuro-fuzzy inference system (ANFIS) algorithm or recursive least squares (RLS) algorithm and wavelet transform (WT) algorithm. The study was conducted on clinical practice data (extended ADFECGDB database and Physionet Challenge 2013 database) from the perspective of non-invasive fetal heart rate variability monitoring based on the determination of the overall probability of correct detection (ACC), sensitivity (SE), positive predictive value (PPV) and harmonic mean between SE and PPV (F1). System functionality was verified against a relevant reference obtained by an invasive way using a scalp electrode (ADFECGDB database), or relevant reference obtained by annotations (Physionet Challenge 2013 database). The study showed that ICA-RLS-WT hybrid system achieve better results than ICA-ANFIS-WT. During experiment on ADFECGDB database, the ICA-RLS-WT hybrid system reached ACC > 80 % on 9 recordings out of 12 and the ICA-ANFIS-WT hybrid system reached ACC > 80 % only on 6 recordings out of 12. During experiment on Physionet Challenge 2013 database the ICA-RLS-WT hybrid system reached ACC > 80 % on 13 recordings out of 25 and the ICA-ANFIS-WT hybrid system reached ACC > 80 % only on 7 recordings out of 25. Both hybrid systems achieve provably better results than the individual algorithms tested in previous studies.Web of Science713178413175

Mathematical tools for identifying the fetal response to physical exercise during pregnancy

In the applied mathematics literature there exist a significant number of tools that can reveal the interaction between mother and fetus during rest and also during and after exercise. These tools are based on techniques from a number of areas such as signal processing, time series analysis, neural networks, heart rate variability as well as dynamical systems and chaos. We will briefly review here some of these methods, concentrating on a method of extracting the fetal heart rate from the mixed maternal-fetal heart rate signal, that is based on phase space reconstructio

Non-invasive Detection and Compression of Fetal Electrocardiogram

Noninvasive detection of fetal electrocardiogram (FECG) from abdominal ECG recordings is highly dependent on typical statistical signal processing techniques such as independent component analysis (ICA), adaptive noise filtering, and multichannel blind deconvolution. In contrast to the previous multichannel FECG extraction methods, several recent schemes for single‐channel FECG extraction such as the extended Kalman filter (EKF), extended Kalman smoother (EKS), template subtraction (TS), and support vector regression (SVR) for detecting R waves on ECG, are evaluated via the quantitative metrics such as sensitivity (SE), positive predictive value (PPV), F‐score, detection error rate (DER), and range of accuracy. A correlation predictor that combines with multivariable gray model (GM) is also proposed for sequential ECG data compression, which displays better percent root mean-square difference (PRD) than those of Sabah’s scheme for fixed and predicted compression ratio (CR). Automatic calculation on fetal heart rate (FHR) on the reconstructed FECG from mixed signals of abdominal ECG recordings is also experimented with sample synthetic ECG data. Sample data on FHR and T/QRS for both physiological case and pathological case are simulated in a 10-min time sequence

Cancellation of the Maternal and Extraction of the Fetal ECG in Noninvasive Recordings

Abstract No signal processin

Nonlinear Adaptive Signal Processing Improves the Diagnostic Quality of Transabdominal Fetal Electrocardiography

The abdominal fetal electrocardiogram (fECG) conveys valuable information that can aid clinicians with the diagnosis and monitoring of a potentially at risk fetus during pregnancy and in childbirth. This chapter primarily focuses on noninvasive (external and indirect) transabdominal fECG monitoring. Even though it is the preferred monitoring method, unlike its classical invasive (internal and direct) counterpart (transvaginal monitoring), it may be contaminated by a variety of undesirable signals that deteriorate its quality and reduce its value in reliable detection of hypoxic conditions in the fetus. A stronger maternal electrocardiogram (the mECG signal) along with technical and biological artifacts constitutes the main interfering signal components that diminish the diagnostic quality of the transabdominal fECG recordings. Currently, transabdominal fECG monitoring relies solely on the determination of the fetus’ pulse or heart rate (FHR) by detecting RR intervals and does not take into account the morphology and duration of the fECG waves (P, QRS, T), intervals, and segments, which collectively convey very useful diagnostic information in adult cardiology. The main reason for the exclusion of these valuable pieces of information in the determination of the fetus’ status from clinical practice is the fact that there are no sufficiently reliable and well-proven techniques for accurate extraction of fECG signals and robust derivation of these informative features. To address this shortcoming in fetal cardiology, we focus on adaptive signal processing methods and pay particular attention to nonlinear approaches that carry great promise in improving the quality of transabdominal fECG monitoring and consequently impacting fetal cardiology in clinical practice. Our investigation and experimental results by using clinical-quality synthetic data generated by our novel fECG signal generator suggest that adaptive neuro-fuzzy inference systems could produce a significant advancement in fetal monitoring during pregnancy and childbirth. The possibility of using a single device to leverage two advanced methods of fetal monitoring, namely noninvasive cardiotocography (CTG) and ST segment analysis (STAN) simultaneously, to detect fetal hypoxic conditions is very promising

Detection and Processing Techniques of FECG Signal for Fetal Monitoring

Fetal electrocardiogram (FECG) signal contains potentially precise information that could assist clinicians in making more appropriate and timely decisions during labor. The ultimate reason for the interest in FECG signal analysis is in clinical diagnosis and biomedical applications. The extraction and detection of the FECG signal from composite abdominal signals with powerful and advance methodologies are becoming very important requirements in fetal monitoring. The purpose of this review paper is to illustrate the various methodologies and developed algorithms on FECG signal detection and analysis to provide efficient and effective ways of understanding the FECG signal and its nature for fetal monitoring. A comparative study has been carried out to show the performance and accuracy of various methods of FECG signal analysis for fetal monitoring. Finally, this paper further focused some of the hardware implementations using electrical signals for monitoring the fetal heart rate. This paper opens up a passage for researchers, physicians, and end users to advocate an excellent understanding of FECG signal and its analysis procedures for fetal heart rate monitoring system

Hybrid methods based on empirical mode decomposition for non-invasive fetal heart rate monitoring

This study focuses on fetal electrocardiogram (fECG) processing using hybrid methods that combine two or more individual methods. Combinations of independent component analysis (ICA), wavelet transform (WT), recursive least squares (RLS), and empirical mode decomposition (EMD) were used to create the individual hybrid methods. Following four hybrid methods were compared and evaluated in this study: ICA-EMD, ICA-EMD-WT, EMD-WT, and ICA-RLS-EMD. The methods were tested on two databases, the ADFECGDB database and the PhysioNet Challenge 2013 database. Extraction evaluation is based on fetal heart rate (fHR) determination. Statistical evaluation is based on determination of correct detection (ACC), sensitivity (Se), positive predictive value (PPV), and harmonic mean between Se and PPV (F1). In this study, the best results were achieved by means of the ICA-RLS-EMD hybrid method, which achieved accuracy(ACC) > 80% at 9 out of 12 recordings when tested on the ADFECGDB database, reaching an average value of ACC > 84%, Se > 87%, PPV > 92%, and F1 > 90%. When tested on the Physionet Challenge 2013 database, ACC > 80% was achieved at 12 out of 25 recordings with an average value of ACC > 64%, Se > 69%, PPV > 79%, and F1 > 72%.Web of Science8512185120

Estrazione non invasiva del segnale elettrocardiografico fetale da registrazioni con elettrodi posti sull’addome della gestante (Non-invasive extraction of the fetal electrocardiogram from abdominal recordings by positioning electrodes on the pregnant woman’s abdomen)

openIl cuore è il primo organo che si sviluppa nel feto, particolarmente nelle primissime settimane di gestazione. Rispetto al cuore adulto, quello fetale ha una fisiologia ed un’anatomia significativamente differenti, a causa della differente circolazione cardiovascolare. Il benessere fetale si valuta monitorando l’attività cardiaca mediante elettrocardiografia fetale (ECGf). L’ECGf invasivo (acquisito posizionando elettrodi allo scalpo fetale) è considerato il gold standard, ma l’invasività che lo caratterizza ne limita la sua applicabilità. Al contrario, l’uso clinico dell’ECGf non invasivo (acquisito posizionando elettrodi sull’addome della gestante) è limitato dalla scarsa qualità del segnale risultante. L’ECGf non invasivo si estrae da registrazioni addominali, che sono corrotte da differenti tipi di rumore, fra i quali l’interferenza primaria è rappresentata dall’ECG materno. Il Segmented-Beat Modulation Method (SBMM) è stato da me recentemente proposto come una nuova procedura di filtraggio basata sul calcolo del template del battito cardiaco. SBMM fornisce una stima ripulita dell’ECG estratto da registrazioni rumorose, preservando la fisiologica variabilità ECG del segnale originale. Questa caratteristica è ottenuta grazie alla segmentazione di ogni battito cardiaco per indentificare i segmenti QRS e TUP, seguito dal processo di modulazione/demodulazione (che include strecciamento e compressione) del segmento TUP, per aggiustarlo in modo adattativo alla morfologia e alla durata di ogni battito originario. Dapprima applicato all’ECG adulto al fine di dimostrare la sua robustezza al rumore, l’SBMM è stato poi applicato al caso fetale. Particolarmente significativi sono i risultati relativi alle applicazioni su ECGf non invasivo, dove l’SBMM fornisce segnali caratterizzati da un rapporto segnale-rumore comparabile a quello caratterizzante l’ECGf invasivo. Tuttavia, l’SBMM può contribuire alla diffusione dell’ECGf non invasiva nella pratica clinica.The heart is the first organ that develops in the fetus, particularly in the very early stages of pregnancy. Compared to the adult heart, the physiology and anatomy of the fetal heart exhibit some significant differences. These differences originate from the fact that the fetal cardiovascular circulation is different from the adult circulation. Fetal well-being evaluation may be accomplished by monitoring cardiac activity through fetal electrocardiography (fECG). Invasive fECG (acquired through scalp electrodes) is the gold standard but its invasiveness limits its clinical applicability. Instead, clinical use of non-invasive fECG (acquired through abdominal electrodes) has so far been limited by its poor signal quality. Non-invasive fECG is extracted from the abdominal recording and is corrupted by different kind of noise, among which maternal ECG is the main interference. The Segmented-Beat Modulation Method (SBMM) was recently proposed by myself as a new template-based filtering procedure able to provide a clean ECG estimation from a noisy recording by preserving physiological ECG variability of the original signal. The former feature is achieved thanks to a segmentation procedure applied to each cardiac beat in order to identify the QRS and TUP segments, followed by a modulation/demodulation process (involving stretching and compression) of the TUP segments to adaptively adjust each estimated cardiac beat to the original beat morphology and duration. SBMM was first applied to adult ECG applications, in order to demonstrate its robustness to noise, and then to fECG applications. Particularly significant are the results relative to the non-invasive applications, where SBMM provided fECG signals characterized by a signal-to-noise ratio comparable to that characterizing invasive fECG. Thus, SBMM may contribute to the spread of this noninvasive fECG technique in the clinical practice.INGEGNERIA DELL'INFORMAZIONEAgostinelli, AngelaAgostinelli, Angel