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Fetal heart rate monitoring device using condenser microphone sensor: Validation and comparison to standard devices

Ahmad HAB, El-Badawy IM, Singh OP, Hisham RB, Malarvili MB

Technol Health Care, 2018;26(4):573-579.
PMID: 29758955 DOI: 10.3233/THC-171067

BACKGROUND: Fetal heart rate (FHR) monitoring device is highly demanded to assess the fetus health condition in home environments. Conventional standard devices such as ultrasonography and cardiotocography are expensive, bulky and uncomfortable and consequently not suitable for long-term monitoring. Herein, we report a device that can be used to measure fetal heart rate in clinical and home environments.
METHODS: The proposed device measures and displays the FHR on a screen liquid crystal display (LCD). The device consists of hardware that comprises condenser microphone sensor, signal conditioning, microcontroller and LCD, and software that involves the algorithm used for processing the conditioned fetal heart signal prior to FHR display. The device's performance is validated based on analysis of variance (ANOVA) test.
RESULTS: FHR data was recorded from 22 pregnant women during the 17th to 37th week of gestation using the developed device and two standard devices; AngelSounds and Electronic Stethoscope. The results show that F-value (1.5) is less than F𝑐𝑟𝑖𝑡, (3.1) and p-value (p> 0.05). Accordingly, there is no significant difference between the mean readings of the developed and existing devices. Hence, the developed device can be used for monitoring FHR in clinical and home environments.

Matched MeSH terms: Fetal Monitoring/instrumentation*; Fetal Monitoring/methods*
Fulltext Advances in obstetric ultrasound

Raman S, Tai C, Neoh HS

Med J Malaysia, 1991 Dec;46(4):314-9.
PMID: 1840438
Matched MeSH terms: Fetal Monitoring
Fetal heart rate monitoring based on independent component analysis

Najafabadi FS, Zahedi E, Mohd Ali MA

Comput Biol Med, 2006 Mar;36(3):241-52.
PMID: 16446158

In this paper, an algorithm based on independent component analysis (ICA) for extracting the fetal heart rate (FHR) from maternal abdominal electrodes is presented. Three abdominal ECG channels are used to extract the FHR in three steps: first preprocessing procedures such as DC cancellation and low-pass filtering are applied to remove noise. Then the algorithm for multiple unknown source extraction (AMUSE) algorithm is fed to extract the sources from the observation signals include fetal ECG (FECG). Finally, FHR is extracted from FECG. The method is shown to be capable of completely revealing FECG R-peaks from observation leads even with a SNR=-200dB using semi-synthetic data.

Matched MeSH terms: Fetal Monitoring/methods*
Transabdominal fetal heart rate detection using NIR photopleythysmography: instrumentation and clinical results

Gan KB, Zahedi E, Mohd Ali MA

IEEE Trans Biomed Eng, 2009 Aug;56(8):2075-82.
PMID: 19403354 DOI: 10.1109/TBME.2009.2021578

In obstetrics, fetal heart rate (FHR) detection remains the standard for intrapartum assessment of fetal well-being. In this paper, a low-power (< 55 mW) optical technique is proposed for transabdominal FHR detection using near-infrared photoplesthysmography (PPG). A beam of IR-LED (890 nm) propagates through to the maternal abdomen and fetal tissues, resulting in a mixed signal detected by a low-noise detector situated at a distance of 4 cm. Low-noise amplification and 24-bit analog-to-digital converter resolution ensure minimum effect of quantization noise. After synchronous detection, the mixed signal is processed by an adaptive filter to extract the fetal signal, whereas the PPG from the mother's index finger is the reference input. A total of 24 datasets were acquired from six subjects at 37 +/- 2 gestational weeks. Results show a correlation coefficient of 0.96 (p-value < 0.001) between the proposed optical and ultrasound FHR, with a maximum error of 4%. Assessment of the effect of probe position on detection accuracy indicates that the probe should be close to fetal tissues, but not necessarily restricted to head or buttocks.

Matched MeSH terms: Fetal Monitoring/instrumentation*; Fetal Monitoring/methods
Fulltext Prenatal heating effects of ultrasound: a review

Nadzirah Mohamad Radzi, Farah Wahida Ahmad Zaiki

Malaysian Journal of Medicine and Health Sciences, 2018;14(3):39-45.
MyJurnal

The application of ultrasound technology has been widely accepted in clinical settings, particularly in Obstetrics and Gynaecology. This is in light of its ability to detect early foetal malformations apart from enabling foetal monitoring throughout gestation. While ultrasonography is an imaging method that is regularly used in Obstetrics, it is questionable as to whether it is safe for foetuses. The purpose of this paper was to review the evidence regarding the thermal effects of ultrasound exposure on foetal development, particularly. It is hoped that the importance of prudent usage of prenatal ultrasonography will be impressed on clinicians and the public in order to avoid the unnecessary usage of ultrasonography when it is not medically indicated. This is so that the welfare of pregnant women will be looked after, besides contributing to the better health of the next generation by ensuring that the benefits outweigh the known risks or potential harms.

Matched MeSH terms: Fetal Monitoring
Fulltext A novel clinical decision support system using improved adaptive genetic algorithm for the assessment of fetal well-being

Ravindran S, Jambek AB, Muthusamy H, Neoh SC

Comput Math Methods Med, 2015;2015:283532.
PMID: 25793009 DOI: 10.1155/2015/283532

A novel clinical decision support system is proposed in this paper for evaluating the fetal well-being from the cardiotocogram (CTG) dataset through an Improved Adaptive Genetic Algorithm (IAGA) and Extreme Learning Machine (ELM). IAGA employs a new scaling technique (called sigma scaling) to avoid premature convergence and applies adaptive crossover and mutation techniques with masking concepts to enhance population diversity. Also, this search algorithm utilizes three different fitness functions (two single objective fitness functions and multi-objective fitness function) to assess its performance. The classification results unfold that promising classification accuracy of 94% is obtained with an optimal feature subset using IAGA. Also, the classification results are compared with those of other Feature Reduction techniques to substantiate its exhaustive search towards the global optimum. Besides, five other benchmark datasets are used to gauge the strength of the proposed IAGA algorithm.

Matched MeSH terms: Fetal Monitoring/methods*
Fulltext Early warning of fetal compromise--absent end diastolic flow?

Neoh HS, Kumarasamy S, Raman S

Med J Malaysia, 1990 Mar;45(1):37-41.
PMID: 2152067

This report deals with the use of a relatively new investigative technique (Doppler ultrasound) in the management of a case of early onset pre-eclampsia and discusses the benefit of this new technique over conventional methods of fetal monitoring.

Matched MeSH terms: Fetal Monitoring*
Fulltext A systematic review of automated pre-processing, feature extraction and classification of cardiotocography

Al-Yousif S, Jaenul A, Al-Dayyeni W, Alamoodi A, Jabori I, Md Tahir N, et al.

PeerJ Comput Sci, 2021;7:e452.
PMID: 33987454 DOI: 10.7717/peerj-cs.452

Context: The interpretations of cardiotocography (CTG) tracings are indeed vital to monitor fetal well-being both during pregnancy and childbirth. Currently, many studies are focusing on feature extraction and CTG classification using computer vision approach in determining the most accurate diagnosis as well as monitoring the fetal well-being during pregnancy. Additionally, a fetal monitoring system would be able to perform detection and precise quantification of fetal heart rate patterns.
Objective: This study aimed to perform a systematic review to describe the achievements made by the researchers, summarizing findings that have been found by previous researchers in feature extraction and CTG classification, to determine criteria and evaluation methods to the taxonomies of the proposed literature in the CTG field and to distinguish aspects from relevant research in the field of CTG.
Methods: Article search was done systematically using three databases: IEEE Xplore digital library, Science Direct, and Web of Science over a period of 5 years. The literature in the medical sciences and engineering was included in the search selection to provide a broader understanding for researchers.
Results: After screening 372 articles, and based on our protocol of exclusion and inclusion criteria, for the final set of articles, 50 articles were obtained. The research literature taxonomy was divided into four stages. The first stage discussed the proposed method which presented steps and algorithms in the pre-processing stage, feature extraction and classification as well as their use in CTG (20/50 papers). The second stage included the development of a system specifically on automatic feature extraction and CTG classification (7/50 papers). The third stage consisted of reviews and survey articles on automatic feature extraction and CTG classification (3/50 papers). The last stage discussed evaluation and comparative studies to determine the best method for extracting and classifying features with comparisons based on a set of criteria (20/50 articles).
Discussion: This study focused more on literature compared to techniques or methods. Also, this study conducts research and identification of various types of datasets used in surveys from publicly available, private, and commercial datasets. To analyze the results, researchers evaluated independent datasets using different techniques.
Conclusions: This systematic review contributes to understand and have insight into the relevant research in the field of CTG by surveying and classifying pertinent research efforts. This review will help to address the current research opportunities, problems and challenges, motivations, recommendations related to feature extraction and CTG classification, as well as the measurement of various performance and various data sets used by other researchers.

Matched MeSH terms: Fetal Monitoring
Reproduction research and health part II--Fetal health

Sinnathuray TA

Med J Malaysia, 1979 Dec;34(2):176-80.
PMID: 548724
Matched MeSH terms: Fetal Monitoring
Real-time signal processing for fetal heart rate monitoring

Ibrahimy MI, Ahmed F, Mohd Ali MA, Zahedi E

IEEE Trans Biomed Eng, 2003 Feb;50(2):258-62.
PMID: 12665042

An algorithm based on digital filtering, adaptive thresholding, statistical properties in the time domain, and differencing of local maxima and minima has been developed for the simultaneous measurement of the fetal and maternal heart rates from the maternal abdominal electrocardiogram during pregnancy and labor for ambulatory monitoring. A microcontroller-based system has been used to implement the algorithm in real-time. A Doppler ultrasound fetal monitor was used for statistical comparison on five volunteers with low risk pregnancies, between 35 and 40 weeks of gestation. Results showed an average percent root mean square difference of 5.32% and linear correlation coefficient from 0.84 to 0.93. The fetal heart rate curves remained inside a +/- 5-beats-per-minute limit relative to the reference ultrasound method for 84.1% of the time.

Matched MeSH terms: Fetal Monitoring/methods*
Severe anti-D haemolytic disease of fetal and newborn in rhesus D negative primigravida

Hassan MZ, Iberahim S, Abdul Rahman WSW, Zulkafli Z, Bahar R, Ramli M, et al.

Malays J Pathol, 2019 Apr;41(1):55-58.
PMID: 31025639

INTRODUCTION: Anti-D alloimmunisation may occur from the blood transfusion or fetomaternal haemorrhage which can lead to haemolytic disease of fetal and newborn (HDFN). The morbidity and mortality of HDFN related to anti-D is significantly reduced after introduction of anti-D prophylaxis and furthermore, anti-D HDFN in RhD negative primigravida is uncommonly seen.
CASE REPORT: A case of unusual severe HDFN due to anti-D alloimmunisation in undiagnosed RhD negative primigravida Malay woman is reported here. This case illustrates the possibility of an anamnestic response from previous unknown sensitisation event or the development of anti-D in mid trimester. The newborn expired due to hydrops fetalis and severe anaemia. Antenatally, the mother was identified as RhD positive and thus there was no antenatal antibody screening, antepartum anti-D prophylaxis or close fetal monitoring for HDFN.
DISCUSSION: The thorough antenatal ABO and RhD blood grouping with antibody screening is mandatory as part of prevention and early detection of HDFN especially due to anti-D alloimmunisation. Improper management of RhD negative women might lead to severe HDFN including in primigravida.

Matched MeSH terms: Fetal Monitoring