Machine learning and disease prediction in obstetrics

Machine learning technologies and translation of artificial intelligence tools to enhance the patient experience are changing obstetric and maternity care. An increasing number of predictive tools have been developed with data sourced from electronic health records, diagnostic imaging and digital devices. In this review, we explore the latest tools of machine learning, the algorithms to establish prediction models and the challenges to assess fetal well-being, predict and diagnose obstetric diseases such as gestational diabetes, pre-eclampsia, preterm birth and fetal growth restriction. We discuss the rapid growth of machine learning approaches and intelligent tools for automated diagnostic imaging of fetal anomalies and to asses fetoplacental and cervix function using ultrasound and magnetic resonance imaging. In prenatal diagnosis, we discuss intelligent tools for magnetic resonance imaging sequencing of the fetus, placenta and cervix to reduce the risk of preterm birth. Finally, the use of machine learning to improve safety standards in intrapartum care and early detection of complications will be discussed. The demand for technologies to enhance diagnosis and treatment in obstetrics and maternity should improve frameworks for patient safety and enhance clinical practice

A Novel Deep Learning Technique for Morphology Preserved Fetal ECG Extraction from Mother ECG using 1D-CycleGAN

Monitoring the electrical pulse of fetal heart through a non-invasive fetal electrocardiogram (fECG) can easily detect abnormalities in the developing heart to significantly reduce the infant mortality rate and post-natal complications. Due to the overlapping of maternal and fetal R-peaks, the low amplitude of the fECG, systematic and ambient noises, typical signal extraction methods, such as adaptive filters, independent component analysis, empirical mode decomposition, etc., are unable to produce satisfactory fECG. While some techniques can produce accurate QRS waves, they often ignore other important aspects of the ECG. Our approach, which is based on 1D CycleGAN, can reconstruct the fECG signal from the mECG signal while maintaining the morphology due to extensive preprocessing and appropriate framework. The performance of our solution was evaluated by combining two available datasets from Physionet, "Abdominal and Direct Fetal ECG Database" and "Fetal electrocardiograms, direct and abdominal with reference heartbeat annotations", where it achieved an average PCC and Spectral-Correlation score of 88.4% and 89.4%, respectively. It detects the fQRS of the signal with accuracy, precision, recall and F1 score of 92.6%, 97.6%, 94.8% and 96.4%, respectively. It can also accurately produce the estimation of fetal heart rate and R-R interval with an error of 0.25% and 0.27%, respectively. The main contribution of our work is that, unlike similar studies, it can retain the morphology of the ECG signal with high fidelity. The accuracy of our solution for fetal heart rate and R-R interval length is comparable to existing state-of-the-art techniques. This makes it a highly effective tool for early diagnosis of fetal heart diseases and regular health checkups of the fetus.Comment: 24 pages, 11 figure

Nature inspired method for noninvasive fetal ECG extraction

This paper introduces a novel algorithm for effective and accurate extraction of non-invasive fetal electrocardiogram (NI-fECG). In NI-fECG based monitoring, the useful signal is measured along with other signals generated by the pregnant women's body, especially maternal electrocardiogram (mECG). These signals are more distinct in magnitude and overlap in time and frequency domains, making the fECG extraction extremely challenging. The proposed extraction method combines the Grey wolf algorithm (GWO) with sequential analysis (SA). This innovative combination, forming the GWO-SA method, optimises the parameters required to create a template that matches the mECG, which leads to an accurate elimination of the said signal from the input composite signal. The extraction system was tested on two databases consisting of real signals, namely, Labour and Pregnancy. The databases used to test the algorithms are available on a server at the generalist repositories (figshare) integrated with Matonia et al. (Sci Data 7(1):1-14, 2020). The results show that the proposed method extracts the fetal ECG signal with an outstanding efficacy. The efficacy of the results was evaluated based on accurate detection of the fQRS complexes. The parameters used to evaluate are as follows: accuracy (ACC), sensitivity (SE), positive predictive value (PPV), and F1 score. Due to the stochastic nature of the GWO algorithm, ten individual runs were performed for each record in the two databases to assure stability as well as repeatability. Using these parameters, for the Labour dataset, we achieved an average ACC of 94.60%, F1 of 96.82%, SE of 97.49%, and PPV of 98.96%. For the Pregnancy database, we achieved an average ACC of 95.66%, F1 of 97.44%, SE of 98.07%, and PPV of 97.44%. The obtained results show that the fHR related parameters were determined accurately for most of the records, outperforming the other state-of-the-art approaches. The poorer quality of certain signals have caused deviation from the estimated fHR for certain records in the databases. The proposed algorithm is compared with certain well established algorithms, and has proven to be accurate in its fECG extractions.Web of Science121art. no. 2015