Fetal heart rate estimation by non-invasive single abdominal electrocardiography in real clinical conditions

Residual convolutional autoencoder combined with a non-negative matrix factorization to estimate fetal heart rate

The fetal heart rate (fHR) plays an important role in the determination of the good health of the fetus. Beside the traditional Doppler ultrasound technique, non-invasive fetal electrocardiography (fECG) has become an interesting alternative. However, extracting clean fECG from abdominal ECG (aECG) recordings is a challenging task due to the presence of the maternal ECG component and various noise sources. In this context, we propose a deep residual convolutional autoencoder network trained on synthetic aECG simulations followed by a transfer learning phase on real aECG recordings to extract the cleanest fECG. Afterwards, we propose to use a non-negative matrix factorization based approach on the obtained fECG to estimate the fHR. Our method is evaluated on three publicly available databases demonstrating that it can provide significant performance improvement against comparative methodologies. Clinical relevance- The presented method has the advantage of estimating the fetal heart rate from a single-channel abdominal electrocardiogram without prior knowledge on the noise sources nor the maternal R-peak locations.

Differences in the Asymmetry of Beat-to-Beat Fetal Heart Rate Accelerations and Decelerations at Preterm and Term Active Labor

The fetal autonomic nervous system responds to uterine contractions during active labor as identified by changes in the accelerations and decelerations of fetal heart rate (FHR). Thus, this exploratory study aimed to characterize the asymmetry differences of beat-to-beat FHR accelerations and decelerations in preterm and term fetuses during active labor. In an observational study, we analyzed 10 min of fetal R-R series collected from women during active preterm labor (32–36 weeks of pregnancy, n = 17) and active term labor (38–40 weeks of pregnancy, n = 27). These data were used to calculate the Deceleration Reserve (DR), which is a novel parameter that quantifies the asymmetry of the average acceleration and deceleration capacity of the heart. In addition, relevant multiscale asymmetric indices of FHR were also computed. Lower values of DR, calculated with the input parameters of T = 50 and s = 10, were associated with labor occurring at the preterm condition (p = 0.0131). Multiscale asymmetry indices also confirmed significant (p < 0.05) differences in the asymmetry of FHR. Fetuses during moderate premature labor may experience more decaying R-R trends and a lower magnitude of decelerations compared to term fetuses. These differences of FHR dynamics might be related to the immaturity of the fetal cardiac autonomic nervous system as identified by this system response to the intense uterine activity at active labor.