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

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

Methods of power line interference elimination in EMG signals

Electromyogram (EMG) recordings are often corrupted by the wide range of artifacts, which one of them is power line interference (PLI). The study focuses on some of the well-known signal processing approaches used to eliminate or attenuate PLI from EMG signal. The results are compared using signal-to-noise ratio (SNR), correlation coefficients and Bland-Altman analysis for each tested method: notch filter, adaptive noise canceller (ANC) and wavelet transform (WT). Thus, the power of the remaining noise and shape of the output signal are analysed. The results show that the ANC method gives the best output SNR and lowest shape distortion compared to the other methods.Web of Science40706

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

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

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

Techniques of FECG signal analysis: detection and processing for fetal monitoring

Fetal heart rate monitoring is a technique for obtaining important information about the condition of a fetus during pregnancy and labor, by detecting the FECG signal generated by the heart of the fetus. 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 is becoming a very important requirement in fetal monitoring. The purpose of this review paper is to illustrate the various methodologies and algorithms on FECG signal detection and analysis to provide efficient and effective ways of understanding the FECG signal and its nature. A comparative study has been carried out to show the performance of various methods. This paper opens up a passage to biomedical researchers, physicians and end users to advocate an excellent understanding of FECG signal and its analysis procedures for fetal heart rate monitoring system by providing valuable information to help them in developing more dominant, flexible and resourceful application

Improving Maternal and Fetal Cardiac Monitoring Using Artificial Intelligence

Early diagnosis of possible risks in the physiological status of fetus and mother during pregnancy and delivery is critical and can reduce mortality and morbidity. For example, early detection of life-threatening congenital heart disease may increase survival rate and reduce morbidity while allowing parents to make informed decisions. To study cardiac function, a variety of signals are required to be collected. In practice, several heart monitoring methods, such as electrocardiogram (ECG) and photoplethysmography (PPG), are commonly performed. Although there are several methods for monitoring fetal and maternal health, research is currently underway to enhance the mobility, accuracy, automation, and noise resistance of these methods to be used extensively, even at home. Artificial Intelligence (AI) can help to design a precise and convenient monitoring system. To achieve the goals, the following objectives are defined in this research: The first step for a signal acquisition system is to obtain high-quality signals. As the first objective, a signal processing scheme is explored to improve the signal-to-noise ratio (SNR) of signals and extract the desired signal from a noisy one with negative SNR (i.e., power of noise is greater than signal). It is worth mentioning that ECG and PPG signals are sensitive to noise from a variety of sources, increasing the risk of misunderstanding and interfering with the diagnostic process. The noises typically arise from power line interference, white noise, electrode contact noise, muscle contraction, baseline wandering, instrument noise, motion artifacts, electrosurgical noise. Even a slight variation in the obtained ECG waveform can impair the understanding of the patient's heart condition and affect the treatment procedure. Recent solutions, such as adaptive and blind source separation (BSS) algorithms, still have drawbacks, such as the need for noise or desired signal model, tuning and calibration, and inefficiency when dealing with excessively noisy signals. Therefore, the final goal of this step is to develop a robust algorithm that can estimate noise, even when SNR is negative, using the BSS method and remove it based on an adaptive filter. The second objective is defined for monitoring maternal and fetal ECG. Previous methods that were non-invasive used maternal abdominal ECG (MECG) for extracting fetal ECG (FECG). These methods need to be calibrated to generalize well. In other words, for each new subject, a calibration with a trustable device is required, which makes it difficult and time-consuming. The calibration is also susceptible to errors. We explore deep learning (DL) models for domain mapping, such as Cycle-Consistent Adversarial Networks, to map MECG to fetal ECG (FECG) and vice versa. The advantages of the proposed DL method over state-of-the-art approaches, such as adaptive filters or blind source separation, are that the proposed method is generalized well on unseen subjects. Moreover, it does not need calibration and is not sensitive to the heart rate variability of mother and fetal; it can also handle low signal-to-noise ratio (SNR) conditions. Thirdly, AI-based system that can measure continuous systolic blood pressure (SBP) and diastolic blood pressure (DBP) with minimum electrode requirements is explored. The most common method of measuring blood pressure is using cuff-based equipment, which cannot monitor blood pressure continuously, requires calibration, and is difficult to use. Other solutions use a synchronized ECG and PPG combination, which is still inconvenient and challenging to synchronize. The proposed method overcomes those issues and only uses PPG signal, comparing to other solutions. Using only PPG for blood pressure is more convenient since it is only one electrode on the finger where its acquisition is more resilient against error due to movement. The fourth objective is to detect anomalies on FECG data. The requirement of thousands of manually annotated samples is a concern for state-of-the-art detection systems, especially for fetal ECG (FECG), where there are few publicly available FECG datasets annotated for each FECG beat. Therefore, we will utilize active learning and transfer-learning concept to train a FECG anomaly detection system with the least training samples and high accuracy. In this part, a model is trained for detecting ECG anomalies in adults. Later this model is trained to detect anomalies on FECG. We only select more influential samples from the training set for training, which leads to training with the least effort. Because of physician shortages and rural geography, pregnant women's ability to get prenatal care might be improved through remote monitoring, especially when access to prenatal care is limited. Increased compliance with prenatal treatment and linked care amongst various providers are two possible benefits of remote monitoring. If recorded signals are transmitted correctly, maternal and fetal remote monitoring can be effective. Therefore, the last objective is to design a compression algorithm that can compress signals (like ECG) with a higher ratio than state-of-the-art and perform decompression fast without distortion. The proposed compression is fast thanks to the time domain B-Spline approach, and compressed data can be used for visualization and monitoring without decompression owing to the B-spline properties. Moreover, the stochastic optimization is designed to retain the signal quality and does not distort signal for diagnosis purposes while having a high compression ratio. In summary, components for creating an end-to-end system for day-to-day maternal and fetal cardiac monitoring can be envisioned as a mix of all tasks listed above. PPG and ECG recorded from the mother can be denoised using deconvolution strategy. Then, compression can be employed for transmitting signal. The trained CycleGAN model can be used for extracting FECG from MECG. Then, trained model using active transfer learning can detect anomaly on both MECG and FECG. Simultaneously, maternal BP is retrieved from the PPG signal. This information can be used for monitoring the cardiac status of mother and fetus, and also can be used for filling reports such as partogram

Wavelet denoising as a post-processing enhancement method for non-invasive foetal electrocardiography

Background and Objective: The detection of a clean and undistorted foetal electrocardiogram (fECG) from non-invasive abdominal recordings is an open research issue. Several physiological and instrumental noise sources hamper this process, even after that powerful fECG extraction algorithms have been used. Wavelet denoising is widely used for the improvement of the SNR in biomedical signal processing. This work aims to systematically assess conventional and unconventional wavelet denoising approaches for the post-processing of fECG signals by providing evidence of their effectiveness in improving fECG SNR while preserving the morphology of the signal of interest. Methods: The stationary wavelet transform (SWT) and the stationary wavelet packet transform (SWPT) were considered, due to their different granularity in the sub-band decomposition of the signal. Three thresholds from the literature, either conventional (Minimax and Universal) and unconventional, were selected. To this aim, the unconventional one was adapted for the first time to SWPT by trying different approaches. The decomposition depth was studied in relation to the characteristics of the fECG signal. Synthetic and real datasets, publicly available for benchmarking and research, were used for quantitative analysis in terms of noise reduction, foetal QRS detection performance and preservation of fECG morphology. Results: The adoption of wavelet denoising approaches generally improved the SNR. Interestingly, the SWT methods outperformed the SWPT ones in morphology preservation (p<0.04) and SNR (p<0.0003), despite their coarser granularity in the sub-band analysis. Remarkably, the Han et al. threshold, adopted for the first time for fECG processing, provided the best quality improvement (p<0.003). Conclusions: The findings of our systematic analysis suggest that particular care must be taken when selecting and using wavelet denoising for non-invasive fECG signal post-processing. In particular, despite the general noise reduction capability, signal morphology can be significantly altered on the basis of the parameterization of the wavelet methods. Remarkably, the adoption of a finer sub-band decomposition provided by the wavelet packet was not able to improve the quality of the processing