Integrating Contrastive Learning and Cycle Generative Adversarial Networks for Non-invasive Fetal ECG Extraction

Fetal electrocardiogram (FECG) contains crucial information about the fetus during pregnancy, making the extraction of FECG signal essential for monitoring fetal health. However, extracting FECG signal from abdominal electrocardiogram (AECG) poses several challenges: (1) FECG signal is often contaminated by noise, and (2) FECG signal is frequently overshadowed by high-amplitude maternal electrocardiogram (MECG). To address these issues and enhance the accuracy of signal extraction, this paper proposes an improved Cycle Generative Adversarial Networks (CycleGAN) with integrated contrastive learning for FECG signal extraction. The model introduces a dual-attention mechanism in the generator of the generative adversarial network, incorporating a multi-head self-attention (MSA) module and a channel-wise self-attention (CSA) module to enhance the quality of generated signals. Additionally, a contrastive triplet loss is integrated into the CycleGAN loss function, optimizing training to increase the similarity between the extracted FECG signal and the scalp fetal electrocardiogram. The proposed method is evaluated using the ADFECG dataset and the PCDB dataset both from the Physionet. In terms of signal extraction quality, Mean Squared Error is reduced to 0.036, Mean Absolute Error (MAE) to 0.009, and Pearson Correlation Coefficient reaches 0.924. When validating the model performance, Structural Similarity Index achieves 95.54%, Peak Signal-to-Noise Ratio (PSNR) reaches 38.87 dB, and R-squared (R2) attains 95.12%. Furthermore, the positive predictive value (PPV), sensitivity (SEN) and F1-score for QRS wave cluster detection on the ADFECG dataset also reached 99.56%, 99.43% and 99.50%, respectively. On the PCDB dataset, the positive predictive value (PPV), sensitivity (SEN) and F1-score for QRS wave cluster detection also reached 98.24%, 98.60% and 98.42%, respectively. All of them are higher than other methods. Therefore, the proposed model has important applications in effective monitoring of fetal health during pregnancy.

Fetal QRS extraction from single-channel abdominal ECG using adaptive improved permutation entropy

Fetal electrocardiogram (fECG) monitoring is crucial for assessing fetal condition during pregnancy. However, current fECG extraction algorithms are not suitable for wearable devices due to their high computational cost and multi-channel signal requirement. The paper introduces a novel and efficient algorithm called Adaptive Improved Permutation Entropy (AIPE), which can extract fetal QRS from a single-channel abdominal ECG (aECG). The proposed algorithm is robust and computationally efficient, making it a reliable and effective solution for wearable devices. To evaluate the performance of the proposed algorithm, we utilized our clinical data obtained from a pilot study with 10 subjects, each recording lasting 20 min. Additionally, data from the PhysioNet 2013 Challenge bank with labeled QRS complex annotations were simulated. The proposed methodology demonstrates an average positive predictive value ( + P ) of 91.0227%, sensitivity (Se) of 90.4726%, and F1 score of 90.6525% from the PhysioNet 2013 Challenge bank, outperforming other methods. The results suggest that AIPE could enable continuous home-based monitoring of unborn babies, even when mothers are not engaging in any hard physical activities.

Joint Improved Fast Independent Component Analysis and Singular Value Decomposition for Fetal Electrocardiogram Extraction

Combined the improved fast independent component analysis (FastICA) algorithm with the singular value decomposition algorithm, a single-channel fetal electrocardiogram (fECG) extraction method is proposed. First, the improved FastICA algorithm is used to estimate the maternal ECG component from a single-channel abdominal signal of pregnant women using an overrelaxation factor. Then, a preliminary estimate of the fECG signal is obtained by subtracting from the single-channel abdominal signal. Subsequently, the singular value decomposition algorithm is used to denoise the preliminarily estimated fECG signal to obtain a high signal-to-noise ratio. In addition, in the singular value decomposition algorithm for fetal arrhythmia, an improved method for constructing the ECG signal reconstruction matrix is proposed. Finally, the fECG extraction experiments on synthetic abdominal signals and actual abdominal signals (data from 49 abdominal channels sourced from DAISY database and the non-invasive fECG database in PhysioNet) are carried out. The experimental results show that the method in this paper can effectively improve the signal-to-noise ratio and the accuracy of fECG signal extraction, and is suitable for maternal or fetal arrhythmias. Compared with the FastICA algorithm, the signal-to-noise ratio of the fECG signal extracted by the method in this paper is improved by about 5 dB, and the accuracy of fECG extraction in the PhysioNet database can reach 96.54%.

A Novel Approach to Fetal ECG Extraction Using Temporal Convolutional Encoder-Decoder Network (TCED-Net)

To extract weak fetal ECG signals from the mixed ECG signal on the mother's abdominal wall, providing a basis for accurately estimating fetal heart rate and analyzing fetal ECG morphology. First, based on the relationship between the maternal chest ECG signal and the maternal ECG component in the abdominal signal, the temporal convolutional encoder-decoder network (TCED-Net) model is trained to fit the nonlinear transmission of the maternal ECG signal from the chest to the abdominal wall. Then, the maternal chest ECG signal is nonlinearly transformed to estimate the maternal ECG component in the abdominal mixed signal. Finally, the estimated maternal ECG component is subtracted from the abdominal mixed signal to obtain the fetal ECG component. The simulation results on the FECGSYN dataset show that the proposed approach achieves the best performance in F1 score, mean square error (MSE), and quality signal-to-noise ratio (qSNR) (98.94%, 0.18, and 8.30, respectively). On the NI-FECG dataset, although the fetal ECG component is small in energy in the mixed signal, this method can effectively suppress the maternal ECG component and thus extract a clearer and more accurate fetal ECG signal. Compared with existing algorithms, the proposed method can extract clearer fetal ECG signals, which has significant application value for effective fetal health monitoring during pregnancy.

Morphology extraction of fetal ECG using temporal CNN-based nonlinear adaptive noise cancelling

OBJECTIVES

Noninvasive fetal electrocardiography (FECG) offers many advantages over alternative fetal monitoring techniques in evaluating fetal health conditions. However, it is difficult to extract a clean FECG signal with morphological features from an abdominal ECG recorded at the maternal abdomen; the signal is usually contaminated by the maternal ECG and various noises. The aim of the work is to extract an FECG signal that preserves the morphological features from the mother's abdominal ECG recording, which allows for accurately estimating the fetal heart rate (FHR) and analyzing the waveforms of the fetal ECG.

METHODS

We propose a novel nonlinear adaptive noise cancelling framework (ANC) based on a temporal convolutional neural network (CNN) to effectively extract fetal ECG signals from mothers' abdominal ECG recordings. The proposed framework consists of a two-stage network, using the ANC architecture; one network is for the maternal ECG component elimination and the other is for the residual noise component removal of the extracted fetal ECG signal. Then, JADE (one of the blind source separation algorithms) is applied as a postprocessing step to produce a clean fetal ECG signal.

RESULTS

Synthetic ECG data (FECGSYNDB) and clinical ECG data (NIFECGDB, PCDB) are used to evaluate the extraction performance of the proposed framework. The statistical and visual results demonstrate that our method outperforms the other state-of-the-art algorithms in the literature. Specifically, on the FECGSYNDB, the mean squared error (MSE), signal-to-noise ratio (SNR), correlation coefficient (R) and F1-score of our method are 0.16, 7.94, 0.95 and 98.89%, respectively. The F1-score on the NIFECGDB reaches 98.62%. The value of the F1-score on the PCDB is 98.62%.

CONCLUSION

As opposed to the existing algorithms being restricted to fetal QRS complex detection, the proposed framework can preserve the morphological features of the extracted fetal ECG signal well, which could support medical diagnoses based on the morphology of the fetal ECG signal.

Lullaby: A Novel Algorithm to Extract Fetal QRS in Real Time Using Periodic Trend Feature

Fetal heart rate (fHR) is an important indicator for monitoring of fetal cardiac health and development. The widely-used method based on ultrasound, however, is not continuous and often requires an expert to perform; thus, it is mostly used in clinics during checkups. The advances in wearable technology have paved the way for home assessment of fHR via the extraction of the mother's abdominal electrocardiogram (ECG) acquired by novel patches. Several methods have been developed for such; however, the computation is either too slow for real-time monitoring or too heavy to be performed in a wearable. In this work, we develop and validate the Lullaby algorithm - a novel method for fetal QRS extraction from aECG. The results showed that Lullaby is almost 7 times faster than existing methods with a better F1-score of 0.815, holding promise to transform perinatal monitoring.

Fetal Electrocardiogram Extraction from the Mother's Abdominal Signal Using the Ensemble Kalman Filter

Fetal electrocardiogram (fECG) assessment is essential throughout pregnancy to monitor the wellbeing and development of the fetus, and to possibly diagnose potential congenital heart defects. Due to the high noise incorporated in the abdominal ECG (aECG) signals, the extraction of fECG has been challenging. And it is even a lot more difficult for fECG extraction if only one channel of aECG is provided, i.e., in a compact patch device. In this paper, we propose a novel algorithm based on the Ensemble Kalman filter (EnKF) for non-invasive fECG extraction from a single-channel aECG signal. To assess the performance of the proposed algorithm, we used our own clinical data, obtained from a pilot study with 10 subjects each of 20 min recording, and data from the PhysioNet 2013 Challenge bank with labeled QRS complex annotations. The proposed methodology shows the average positive predictive value (PPV) of 97.59%, sensitivity (SE) of 96.91%, and F1-score of 97.25% from the PhysioNet 2013 Challenge bank. Our results also indicate that the proposed algorithm is reliable and effective, and it outperforms the recently proposed extended Kalman filter (EKF) based algorithm.

Fetal ECG Extraction from Maternal ECG using Attention-based CycleGAN

A non-invasive fetal electrocardiogram (FECG) is used to monitor the electrical pulse of the fetal heart. Decomposing the FECG signal from the maternal ECG (MECG) is a blind source separation problem, which is hard due to the low amplitude of the FECG, the overlap of R waves, and the potential exposure to noise from different sources. Traditional decomposition techniques, such as adaptive filters, require tuning, alignment, or pre-configuration, such as modeling the noise or desired signal to map the MECG to the FECG. The high correlation between maternal and fetal ECG fragments decreases the performance of convolution layers. Therefore, the masking region of interest based on the attention mechanism was performed to improve the signal generators' precision. The sine activation function was also used to retain more details when converting two signal domains. Three available datasets from the Physionet, including the A&D FECG, NI-FECG, and NI-FECG challenge, and one synthetic dataset using FECGSYN toolbox, were used to evaluate the performance. The proposed method could map an abdominal MECG to a scalp FECG with an average of 98% R-Square [CI 95%: 97%, 99%] as the goodness of fit on the A&D FECG dataset. Moreover, it achieved 99.7 % F1-score [CI 95%: 97.8-99.9], 99.6% F1-score [CI 95%: 98.2%, 99.9%] and 99.3% F1-score [CI 95%: 95.3%, 99.9%] for fetal QRS detection on the A&D FECG, NI-FECG and NI-FECG challenge datasets, respectively. Also, the distortion was in the very good and good ranges. These results are comparable to the state-of-the-art results; thus, the proposed algorithm has the potential to be used for high-performance signal-to-signal conversion.

A novel algorithm based on ensemble empirical mode decomposition for non-invasive fetal ECG extraction

Non-invasive fetal electrocardiography appears to be one of the most promising fetal monitoring techniques during pregnancy and delivery nowadays. This method is based on recording electrical potentials produced by the fetal heart from the surface of the maternal abdomen. Unfortunately, in addition to the useful fetal electrocardiographic signal, there are other interference signals in the abdominal recording that need to be filtered. The biggest challenge in designing filtration methods is the suppression of the maternal electrocardiographic signal. This study focuses on the extraction of fetal electrocardiographic signal from abdominal recordings using a combination of independent component analysis, recursive least squares, and ensemble empirical mode decomposition. The method was tested on two databases, the Fetal Electrocardiograms, Direct and Abdominal with Reference Heartbeats Annotations and the PhysioNet Challenge 2013 database. The evaluation was performed by the assessment of the accuracy of fetal QRS complexes detection and the quality of fetal heart rate determination. The effectiveness of the method was measured by means of the statistical parameters as accuracy, sensitivity, positive predictive value, and F1-score. Using the proposed method, when testing on the Fetal Electrocardiograms, Direct and Abdominal with Reference Heartbeats Annotations database, accuracy higher than 80% was achieved for 11 out of 12 recordings with an average value of accuracy 92.75% [95% confidence interval: 91.19-93.88%], sensitivity 95.09% [95% confidence interval: 93.68-96.03%], positive predictive value 96.36% [95% confidence interval: 95.05-97.17%] and F1-score 95.69% [95% confidence interval: 94.83-96.35%]. When testing on the Physionet Challenge 2013 database, accuracy higher than 80% was achieved for 17 out of 25 recordings with an average value of accuracy 78.24% [95% confidence interval: 73.44-81.85%], sensitivity 81.79% [95% confidence interval: 76.59-85.43%], positive predictive value 87.16% [95% confidence interval: 81.95-90.35%] and F1-score 84.08% [95% confidence interval: 80.75-86.64%]. Moreover, the non-invasive ST segment analysis was carried out on the records from the Fetal Electrocardiograms, Direct and Abdominal with Reference Heartbeats Annotations database and achieved high accuracy in 7 from in total of 12 records (mean values μ < 0.1 and values of ±1.96σ < 0.1).

Clifford Wavelet Entropy for Fetal ECG Extraction

Analysis of the fetal heart rate during pregnancy is essential for monitoring the proper development of the fetus. Current fetal heart monitoring techniques lack the accuracy in fetal heart rate monitoring and features acquisition, resulting in diagnostic medical issues. The challenge lies in the extraction of the fetal ECG from the mother ECG during pregnancy. This approach has the advantage of being a reliable and non-invasive technique. In the present paper, a wavelet/multiwavelet method is proposed to perfectly extract the fetal ECG parameters from the abdominal mother ECG. In a first step, due to the wavelet/mutiwavelet processing, a denoising procedure is applied to separate the noised parts from the denoised ones. The denoised signal is assumed to be a mixture of both the MECG and the FECG. One of the well-known measures of accuracy in information processing is the concept of entropy. In the present work, a wavelet/multiwavelet Shannon-type entropy is constructed and applied to evaluate the order/disorder of the extracted FECG signal. The experimental results apply to a recent class of Clifford wavelets constructed in Arfaoui, et al. J. Math. Imaging Vis. 2020, 62, 73-97, and Arfaoui, et al.Acta Appl. Math.2020, 170, 1-35.. Additionally, classical Haar-Faber-Schauder wavelets are applied for the purpose of comparison. Two main well-known databases have been applied, the DAISY database and the CinC Challenge 2013 database. The achieved accuracy over the test databases resulted in Se=100%, PPV=100% for FECG extraction and peak detection.

AECG-DecompNet: abdominal ECG signal decomposition through deep-learning model

Objective.The accurate decomposition of a mother's abdominal electrocardiogram (AECG) to extract the fetal ECG (FECG) is a primary step in evaluating the fetus's health. However, the AECG is often affected by different noises and interferences, such as the maternal ECG (MECG), making it hard to evaluate the FECG signal. In this paper, we propose a deep-learning-based framework, namely 'AECG-DecompNet', to efficiently extract both MECG and FECG from a single-channel abdominal electrode recording.Approach.AECG-DecompNet is based on two series networks to decompose AECG, one for MECG estimation and the other to eliminate interference and noise. Both networks are based on an encoder-decoder architecture with internal and external skip connections to reconstruct the signals better.Main results.Experimental results show that the proposed framework performs much better than utilizing one network for direct FECG extraction. In addition, the comparison of the proposed framework with popular single-channel extraction techniques shows superior results in terms of QRS detection while indicating its ability to preserve morphological information. AECG-DecompNet achieves exceptional accuracy in theprecisionmetric (97.4%), higher accuracy inrecallandF₁metrics (93.52% and 95.42% respectively), and outperforms other state-of-the-art approaches.Significance.The proposed method shows a notable performance in preserving the morphological information when the FECG within the AECG signal is weak.

An improved parallel sub-filter adaptive noise canceler for the extraction of fetal ECG

Non-invasive extraction of fetal electrocardiogram (FECG) by processing the abdominal signals is emerging as a promising approach in the areas of obstetrics and gynecology. This paper presents a two-stage improved non-linear adaptive filter for FECG extraction. The reference input to the adaptive noise canceler (ANC) is first processed using an adaptive neuro-fuzzy inference system (ANFIS) to estimate the non-linear maternal component in abdominal signals. A parallel sub-filter (PSF) ANC is proposed to assess the fetal ECG from the abdominal signal. The PSF-ANC decomposes a single adaptive filter into multiple sub-filters to improve the convergence performance. The filter coefficients of PSF-ANC adaptively obtained using normalised least mean square algorithm by minimizing the mean square error. Different error and common error algorithms are proposed based on the computation of the error signal. A synthetic data from the FECG synthetic database is used to evaluate the convergence performance. Two real-time data from the Daisy database and the Non-invasive FECG database from Physionet are used to evaluate the proposed ANFIS-PSF's performance qualitative and quantitatively. The results justify the performance improvement of proposed ANFIS-PSF ANC compared to the state of art techniques. The proposed scheme achieves a sensitivity of 97.92%, 94.52% accuracy, a positive predictive value of 94.66%, and an F1 score of 96.12%.

A Null Space-Based Blind Source Separation for Fetal Electrocardiogram Signals

This paper presents a new non-invasive deterministic algorithm of extracting the fetal Electrocardiogram (FECG) signal based on a new null space idempotent transformation matrix (NSITM). The mixture matrix is used to compute the ITM. Then, the fetal ECG (FECG) and maternal ECG (MECG) signals are extracted from the null space of the ITM. Next, MECG and FECG peaks detection, control logic, and adaptive comb filter are used to remove the unwanted MECG component from the raw FECG signal, thus extracting a clean FECG signal. The visual results from Daisy and Physionet real databases indicate that the proposed algorithm is effective in extracting the FECG signal, which can be compared with principal component analysis (PCA), fast independent component analysis (FastICA), and parallel linear predictor (PLP) filter algorithms. Results from Physionet synthesized ECG data show considerable improvement in extraction performances over other algorithms used in this work, considering different additive signal-to-noise ratio (SNR) increasing from 0 dB to 12 dB, and considering different fetal-to-maternal SNR increasing from -30 dB to 0 dB. The FECG detection of the NSITM is evaluated using statistical measures and results show considerable improvement in the sensitivity (SE), the accuracy (ACC), and the positive predictive value (PPV), as compared with other algorithms. The study demonstrated that the NSITM is a feasible algorithm for FECG extraction.

End-to-end trained encoder-decoder convolutional neural network for fetal electrocardiogram signal denoising

OBJECTIVE

Non-invasive fetal electrocardiography has the potential to provide vital information for evaluating the health status of the fetus. However, the low signal-to-noise ratio of the fetal electrocardiogram (ECG) impedes the applicability of the method in clinical practice. Quality improvement of the fetal ECG is of great importance for providing accurate information to enable support in medical decision-making. In this paper we propose the use of artificial intelligence for the task of one-channel fetal ECG enhancement as a post-processing step after maternal ECG suppression.

APPROACH

We propose a deep fully convolutional encoder-decoder framework, learning end-to-end mappings from noise-contaminated fetal ECGs to clean ones. Symmetric skip-layer connections are used between corresponding convolutional and transposed convolutional layers to help recover the signal details.

MAIN RESULTS

Experiments on synthetic data show an average improvement of 7.5 dB in the signal-to-noise ratio (SNR) for input SNRs in the range of  -15 to 15 dB. Application of the method with real signals and subsequent ECG interval analysis demonstrates a root mean square error of 9.9 and 14 ms for the PR and QT intervals, respectively, when compared with simultaneous scalp measurements. The proposed network can achieve substantial noise removal on both synthetic and real data. In cases of highly noise-contaminated signals some morphological features might be unreliably reconstructed.

SIGNIFICANCE

The presented method has the advantage of preserving individual variations in pulse shape and beat-to-beat intervals. Moreover, no prior knowledge on the power spectra of the noise or the pulse locations is required.

Recovery of the fetal electrocardiogram for morphological analysis from two trans-abdominal channels via optimal shrinkage

OBJECTIVE

We propose a novel algorithm to recover fetal electrocardiogram (ECG) for both the fetal heart rate analysis and morphological analysis of its waveform from two or three trans-abdominal maternal ECG channels.

APPROACH

We design an algorithm based on the optimal-shrinkage under the wave-shape manifold model. For the fetal heart rate analysis, the algorithm is evaluated on publicly available database, 2013 PhyioNet/Computing in Cardiology Challenge, set A (CinC2013). For the morphological analysis, we analyze CinC2013 and another publicly available database, non-invasive fetal ECG arrhythmia database (nifeadb), and propose to simulate semi-real databases by mixing the MIT-BIH normal sinus rhythm database and MITDB arrhythmia database.

MAIN RESULTS

For the fetal R peak detection, the proposed algorithm outperforms all algorithms under comparison. For the morphological analysis, the algorithm provides an encouraging result in recovery of the fetal ECG waveform, including PR, QT and ST intervals, even when the fetus has arrhythmia, both in real and simulated databases.

SIGNIFICANCE

To the best of our knowledge, this is the first work focusing on recovering the fetal ECG for morphological analysis from two or three channels with an algorithm potentially applicable for continuous fetal electrocardiographic monitoring, which creates the potential for long term monitoring purpose.

An Efficient Adaptive Filter for Fetal ECG Extraction Using Neural Network

Fetal electrocardiogram checking is a strategy for acquiring critical data about the state of the fetus during pregnancy and labor. This is done by measuring electrical signals created by the fetal heart as measured from multichannel potential recordings on the mother’s body surface. In any case, extraction of fetal signal is difficult because the signal is marred by the mother’s heartbeat signal. Subsequently, in this paper, a powerful versatile filtering strategy is utilized to eliminate the mother’s heartbeat signal with the specific end goal of extricating the fetal signal. The proposed procedure was executed in the working stage of MATLAB and the execution results were investigated.

A Review of Signal Processing Techniques for Non-Invasive Fetal Electrocardiography

Fetal electrocardiography (fECG) is a promising alternative to cardiotocography continuous fetal monitoring. Robust extraction of the fetal signal from the abdominal mixture of maternal and fetal electrocardiograms presents the greatest challenge to effective fECG monitoring. This is mainly due to the low amplitude of the fetal versus maternal electrocardiogram and to the non-stationarity of the recorded signals. In this review, we highlight key developments in advanced signal processing algorithms for non-invasive fECG extraction and the available open access resources (databases and source code). In particular, we highlight the advantages and limitations of these algorithms as well as key parameters that must be set to ensure their optimal performance. Improving or combining the current or developing new advanced signal processing methods may enable morphological analysis of the fetal electrocardiogram, which today is only possible using the invasive scalp electrocardiography method.

NEW METHOD EXPLOITING A HYBRID TECHNIQUES FOR FETAL CARDIAC SIGNAL EXTRACTION

According to WHO, 2.6 million babies die during pregnancy. Good monitoring during the prenatal period could provide a significant reduction of this mortality rate. This is possible by detection and extraction of the fetal electrocardiogram (FECG). Extraction of that information is complex due to other noise coming from the mother and within the fetus that drowns out the fetal heart signal. However, new technology and improved filtering technique have provided ways to more accurately and efficiently gather various electrical components regarding fetal heart condition. In this paper, we propose a new source separation filtering method exploiting linear and nonlinear filtering techniques. Our method is a non-invasive extraction technique, where the source signal is the cardiac electrical signal acquired by non-invasive electrodes to facilitate the collection of signals and reduce the cost of the acquisition system; it differs from other existing methods in minimizing the number of input signals and the simplicity of its implementation. The fetal heart signal is drowned out by the maternal electrocardiogram (MECG). The problem that arises is the exact knowledge of the MECG signal affecting the chosen measuring electrode, since the MECG is dependent on the position of the electrode and the type of tissue that goes through. Therefore, its knowledge can be made only by a mathematical estimation. A DWT decomposition with adaptive thresholding based on an LMS filter is applied to extract the fetal signal. So first we extract the QRS complex of the FECG and detect the fetal heart rate (FHR).

Extraction of foetal ECG from abdominal ECG by nonlinear transformation and estimations

BACKGROUND AND OBJECTIVE

This paper proposes a simple yet effective method for the extraction of foetal ECG from abdominal ECG which is necessary due to similar spatial and temporal content of mother and foetal ECG.

METHODS

The proposed algorithm for extraction of foetal ECG (fECG) from abdominal signal uses single channel. Pre-processing of abdominal ECG (abdECG) has been done to eliminate noise and condition the signal. The maternal ECG R-peaks have been detected based on thresholding, first order Gaussian differentiation and zero cross detection on pre-processed signal. Having identified R-peaks and pre-processed signal as base, using Maximum Likelihood Estimation, one beat including QRS complex morphology of maternal ECG (mECG) has been constructed. Extraction of maternal ECG from abdECG is done based on the constructed beat, R-peak locations and its corresponding QRS complex of abdECG. Extracted mECG has been cancelled from abdECG. This results in foetal ECG with residual noise. The noise has been reduced by Polynomial Approximation and Total Variation (PATV) to improve SNR. This approach ensures no loss of partially or completely overlapped fECG signals due to mECG removal. The algorithm is tested on three database namely daISy (DB_I), Physiobank challenge 2013 (DB_II) and abdominal and direct foetal ECG database (adfecgdb) of Physiobank (DB_III).

RESULTS

The algorithm detected no false positives or false negatives with certain channel for DB_I, DB_II and DB_III which shows that the proposed algorithm can achieve good performance. Overall accuracy and sensitivity of the system is 98.53% and 100% for DB_I. Best accuracy and sensitivity of 97.77% and 98.63% are obtained for DB_II. Best accuracy of 92.41% and sensitivity of 93.8% are obtained for DB_III. Correlation coefficient between actual foetal heart rate (fHR) and estimated fHR of 0.66 for DB_II and 0.59 for DB_III is obtained. The method has obtained overall F1 score of 99.25% for DB_I, 96.04% for DB_II and 94.25% for DB_III. It has obtained a best MSE of fHR and overall MSE of R-R interval which is 10.8bpm² and 2.2 ms for DB_II, 12bpm² and 2.14 ms for DB_III.

CONCLUSION

The results for different public databases show that the proposed method is capable of providing good results. The foetal QRS, R-peaks and R-R intervals have also been obtained in this method. Thus, it gives a significant contribution in the required area of research.

Fetal ECG extraction from time-varying and low-rank noninvasive maternal abdominal recordings

OBJECTIVE

Noninvasive fetal electrocardiography is emerging as a low-cost and high-accuracy technology for fetal cardiac monitoring. Signal processing techniques have been used over the past fifty years in this domain. The current major challenges of this domain, addressed in this study are (1) fetal electrocardiogram (fECG) extraction from few numbers of maternal abdominal channels in low signal-to-noise ratios; (2) online fECG extraction; (3) automatic and online signal quality assessment and channel selection; and (4) accurate and robust fetal R-peak detection and ECG parameter extraction.

APPROACH

Based on the theory of cyclostationarity, auxiliary maternal ECG channel(s) are synthetically constructed and augmented with the input channels. The augmented data are used to develop a robust multichannel source separation algorithm for online/offline fECG extraction, from as few as a single channel, and an accurate fetal R-peak detector using a two-pass matched filter. Several robust signal quality indexes (SQI) and a voting strategy are also proposed for automatic fetal signal quality assessment.

MAIN RESULTS

It is shown that the fECG and the fetal R-peaks can be accurately extracted from standard online available datasets, for which classical source separation methods (requiring many channels) had previously failed. The signal quality indexes fully automate the extraction and channel selection procedure. Finally, the proposed R-peak detector is highly robust to background noise and residual maternal R-peak components.

SIGNIFICANCE

The proposed methods for fECG extraction, R-peak detection and automatic channel selection are evaluated (visually and numerically), on two online available datasets and compared with recently developed algorithms. The proposed algorithm is statistically shown to outperform the benchmarks in terms of average and standard deviation.

Enhancement of low-quality fetal electrocardiogram based on time-sequenced adaptive filtering

Extraction of a clean fetal electrocardiogram (ECG) from non-invasive abdominal recordings is one of the biggest challenges in fetal monitoring. An ECG allows for the interpretation of the electrical heart activity beyond the heart rate and heart rate variability. However, the low signal quality of the fetal ECG hinders the morphological analysis of its waveform in clinical practice. The time-sequenced adaptive filter has been proposed for performing optimal time-varying filtering of non-stationary signals having a recurring statistical character. In our study, the time-sequenced adaptive filter is applied to enhance the quality of multichannel fetal ECG after the maternal ECG is removed. To improve the performance of the filter in cases of low signal-to-noise ratio (SNR), we enhance the ECG reference signals by averaging consecutive ECG complexes. The performance of the proposed augmented time-sequenced adaptive filter is evaluated in both synthetic and real data from PhysioNet. This evaluation shows that the suggested algorithm clearly outperforms other ECG enhancement methods, in terms of uncovering the ECG waveform, even in cases with very low SNR. With the presented method, quality of the fetal ECG morphology can be enhanced to the extent that the ECG might be fit for use in clinical diagnostics.

Graphical abstract

Comparative Effectiveness of ICA and PCA in Extraction of Fetal ECG From Abdominal Signals: Toward Non-invasive Fetal Monitoring

Non-adaptive signal processing methods have been successfully applied to extract fetal electrocardiograms (fECGs) from maternal abdominal electrocardiograms (aECGs); and initial tests to evaluate the efficacy of these methods have been carried out by using synthetic data. Nevertheless, performance evaluation of such methods using real data is a much more challenging task and has neither been fully undertaken nor reported in the literature. Therefore, in this investigation, we aimed to compare the effectiveness of two popular non-adaptive methods (the ICA and PCA) to explore the non-invasive (NI) extraction (separation) of fECGs, also known as NI-fECGs from aECGs. The performance of these well-known methods was enhanced by an adaptive algorithm, compensating amplitude difference and time shift between the estimated components. We used real signals compiled in 12 recordings (real01-real12). Five of the recordings were from the publicly available database (PhysioNet-Abdominal and Direct Fetal Electrocardiogram Database), which included data recorded by multiple abdominal electrodes. Seven more recordings were acquired by measurements performed at the Institute of Medical Technology and Equipment, Zabrze, Poland. Therefore, in total we used 60 min of data (i.e., around 88,000 R waves) for our experiments. This dataset covers different gestational ages, fetal positions, fetal positions, maternal body mass indices (BMI), etc. Such a unique heterogeneous dataset of sufficient length combining continuous Fetal Scalp Electrode (FSE) acquired and abdominal ECG recordings allows for robust testing of the applied ICA and PCA methods. The performance of these signal separation methods was then comprehensively evaluated by comparing the fetal Heart Rate (fHR) values determined from the extracted fECGs with those calculated from the fECG signals recorded directly by means of a reference FSE. Additionally, we tested the possibility of non-invasive ST analysis (NI-STAN) by determining the T/QRS ratio. Our results demonstrated that even though these advanced signal processing methods are suitable for the non-invasive estimation and monitoring of the fHR information from maternal aECG signals, their utility for further morphological analysis of the extracted fECG signals remains questionable and warrants further work.

Single-Lead Fetal ECG Extraction Based on a Parallel Marginalized Particle Filter

This paper presents a novel method for extracting the fetal ECG (FECG) from a single-lead abdominal signal. A dynamical model for a modified abdominal signal is proposed, in which both the maternal ECG (MECG) and the FECG are modeled, and then a parallel marginalized particle filter (par-MPF) is used for tracking the abdominal signal. Finally, the FECG and MECG are simultaneously separated. Several experiments are conducted using both simulated and clinical signals. The results indicate that the method proposed in this paper effectively extracts the FECG and outperforms other Bayesian filtering algorithms.

Non-Invasive Fetal Monitoring: A Maternal Surface ECG Electrode Placement-Based Novel Approach for Optimization of Adaptive Filter Control Parameters Using the LMS and RLS Algorithms

This paper is focused on the design, implementation and verification of a novel method for the optimization of the control parameters (such as step size μ and filter order N) of LMS and RLS adaptive filters used for noninvasive fetal monitoring. The optimization algorithm is driven by considering the ECG electrode positions on the maternal body surface in improving the performance of these adaptive filters. The main criterion for optimal parameter selection was the Signal-to-Noise Ratio (SNR). We conducted experiments using signals supplied by the latest version of our LabVIEW-Based Multi-Channel Non-Invasive Abdominal Maternal-Fetal Electrocardiogram Signal Generator, which provides the flexibility and capability of modeling the principal distribution of maternal/fetal ECGs in the human body. Our novel algorithm enabled us to find the optimal settings of the adaptive filters based on maternal surface ECG electrode placements. The experimental results further confirmed the theoretical assumption that the optimal settings of these adaptive filters are dependent on the ECG electrode positions on the maternal body, and therefore, we were able to achieve far better results than without the use of optimization. These improvements in turn could lead to a more accurate detection of fetal hypoxia. Consequently, our approach could offer the potential to be used in clinical practice to establish recommendations for standard electrode placement and find the optimal adaptive filter settings for extracting high quality fetal ECG signals for further processing. Ultimately, diagnostic-grade fetal ECG signals would ensure the reliable detection of fetal hypoxia.

Efficient Fetal-Maternal ECG Signal Separation from Two Channel Maternal Abdominal ECG via Diffusion-Based Channel Selection

There is a need for affordable, widely deployable maternal-fetal ECG monitors to improve maternal and fetal health during pregnancy and delivery. Based on the diffusion-based channel selection, here we present the mathematical formalism and clinical validation of an algorithm capable of accurate separation of maternal and fetal ECG from a two channel signal acquired over maternal abdomen. The proposed algorithm is the first algorithm, to the best of the authors' knowledge, focusing on the fetal ECG analysis based on two channel maternal abdominal ECG signal, and we apply it to two publicly available databases, the PhysioNet non-invasive fECG database (adfecgdb) and the 2013 PhysioNet/Computing in Cardiology Challenge (CinC2013), to validate the algorithm. The state-of-the-art results are achieved when compared with other available algorithms. Particularly, the F₁ score for the R peak detection achieves 99.3% for the adfecgdb and 87.93% for the CinC2013, and the mean absolute error for the estimated R peak locations is 4.53 ms for the adfecgdb and 6.21 ms for the CinC2013. The method has the potential to be applied to other fetal cardiogenic signals, including cardiac doppler signals.

Fetal ECG extraction via Type-2 adaptive neuro-fuzzy inference systems

BACKGROUND AND OBJECTIVE

We proposed a noninvasive method for separating the fetal ECG (FECG) from maternal ECG (MECG) by using Type-2 adaptive neuro-fuzzy inference systems.

METHODS

The method can extract FECG components from abdominal signal by using one abdominal channel, including maternal and fetal cardiac signals and other environmental noise signals, and one chest channel. The proposed algorithm detects the nonlinear dynamics of the mother's body. So, the components of the MECG are estimated from the abdominal signal. By subtracting estimated mother cardiac signal from abdominal signal, fetal cardiac signal can be extracted. This algorithm was applied on synthetic ECG signals generated based on the models developed by McSharry et al. and Behar et al. and also on DaISy real database.

RESULTS

In environments with high uncertainty, our method performs better than the Type-1 fuzzy method. Specifically, in evaluation of the algorithm with the synthetic data based on McSharry model, for input signals with SNR of -5dB, the SNR of the extracted FECG was improved by 38.38% in comparison with the Type-1 fuzzy method. Also, the results show that increasing the uncertainty or decreasing the input SNR leads to increasing the percentage of the improvement in SNR of the extracted FECG. For instance, when the SNR of the input signal decreases to -30dB, our proposed algorithm improves the SNR of the extracted FECG by 71.06% with respect to the Type-1 fuzzy method. The same results were obtained on synthetic data based on Behar model. Our results on real database reflect the success of the proposed method to separate the maternal and fetal heart signals even if their waves overlap in time. Moreover, the proposed algorithm was applied to the simulated fetal ECG with ectopic beats and achieved good results in separating FECG from MECG.

CONCLUSIONS

The results show the superiority of the proposed Type-2 neuro-fuzzy inference method over the Type-1 neuro-fuzzy inference and the polynomial networks methods, which is due to its capability to capture the nonlinearities of the model better.

A Novel Technique for Fetal ECG Extraction Using Single-Channel Abdominal Recording

Non-invasive fetal electrocardiograms (FECGs) are an alternative method to standard means of fetal monitoring which permit long-term continual monitoring. However, in abdominal recording, the FECG amplitude is weak in the temporal domain and overlaps with the maternal electrocardiogram (MECG) in the spectral domain. Research in the area of non-invasive separations of FECG from abdominal electrocardiograms (AECGs) is in its infancy and several studies are currently focusing on this area. An adaptive noise canceller (ANC) is commonly used for cancelling interference in cases where the reference signal only correlates with an interference signal, and not with a signal of interest. However, results from some existing studies suggest that propagation of electrocardiogram (ECG) signals from the maternal heart to the abdomen is nonlinear, hence the adaptive filter approach may fail if the thoracic and abdominal MECG lack strict waveform similarity. In this study, singular value decomposition (SVD) and smooth window (SW) techniques are combined to build a reference signal in an ANC. This is to avoid the limitation that thoracic MECGs recorded separately must be similar to abdominal MECGs in waveform. Validation of the proposed method with r01 and r07 signals from a public dataset, and a self-recorded private dataset showed that the proposed method achieved F1 scores of 99.61%, 99.28% and 98.58%, respectively for the detection of fetal QRS. Compared with four other single-channel methods, the proposed method also achieved higher accuracy values of 99.22%, 98.57% and 97.21%, respectively. The findings from this study suggest that the proposed method could potentially aid accurate extraction of FECG from MECG recordings in both clinical and commercial applications.

Extraction of fetal ECG signal by an improved method using extended Kalman smoother framework from single channel abdominal ECG signal

This paper proposes a five-stage based methodology to extract the fetal electrocardiogram (FECG) from the single channel abdominal ECG using differential evolution (DE) algorithm, extended Kalman smoother (EKS) and adaptive neuro fuzzy inference system (ANFIS) framework. The heart rate of the fetus can easily be detected after estimation of the fetal ECG signal. The abdominal ECG signal contains fetal ECG signal, maternal ECG component, and noise. To estimate the fetal ECG signal from the abdominal ECG signal, removal of the noise and the maternal ECG component presented in it is necessary. The pre-processing stage is used to remove the noise from the abdominal ECG signal. The EKS framework is used to estimate the maternal ECG signal from the abdominal ECG signal. The optimized parameters of the maternal ECG components are required to develop the state and measurement equation of the EKS framework. These optimized maternal ECG parameters are selected by the differential evolution algorithm. The relationship between the maternal ECG signal and the available maternal ECG component in the abdominal ECG signal is nonlinear. To estimate the actual maternal ECG component present in the abdominal ECG signal and also to recognize this nonlinear relationship the ANFIS is used. Inputs to the ANFIS framework are the output of EKS and the pre-processed abdominal ECG signal. The fetal ECG signal is computed by subtracting the output of ANFIS from the pre-processed abdominal ECG signal. Non-invasive fetal ECG database and set A of 2013 physionet/computing in cardiology challenge database (PCDB) are used for validation of the proposed methodology. The proposed methodology shows a sensitivity of 94.21%, accuracy of 90.66%, and positive predictive value of 96.05% from the non-invasive fetal ECG database. The proposed methodology also shows a sensitivity of 91.47%, accuracy of 84.89%, and positive predictive value of 92.18% from the set A of PCDB.

Robust fetal QRS detection from noninvasive abdominal electrocardiogram based on channel selection and simultaneous multichannel processing

The purpose of this study is to provide a new method for detecting fetal QRS complexes from non-invasive fetal electrocardiogram (fECG) signal. Despite most of the current fECG processing methods which are based on separation of fECG from maternal ECG (mECG), in this study, fetal heart rate (FHR) can be extracted with high accuracy without separation of fECG from mECG. Furthermore, in this new approach thoracic channels are not necessary. These two aspects have reduced the required computational operations. Consequently, the proposed approach can be efficiently applied to different real-time healthcare and medical devices. In this work, a new method is presented for selecting the best channel which carries strongest fECG. Each channel is scored based on two criteria of noise distribution and good fetal heartbeat visibility. Another important aspect of this study is the simultaneous and combinatorial use of available fECG channels via the priority given by their scores. A combination of geometric features and wavelet-based techniques was adopted to extract FHR. Based on fetal geometric features, fECG signals were divided into three categories, and different strategies were employed to analyze each category. The method was validated using three datasets including Noninvasive fetal ECG database, DaISy and PhysioNet/Computing in Cardiology Challenge 2013. Finally, the obtained results were compared with other studies. The adopted strategies such as multi-resolution analysis, not separating fECG and mECG, intelligent channels scoring and using them simultaneously are the factors that caused the promising performance of the method.

Sequential Total Variation Denoising for the Extraction of Fetal ECG from Single-Channel Maternal Abdominal ECG

Fetal heart rate (FHR) is an important determinant of fetal health. Cardiotocography (CTG) is widely used for measuring the FHR in the clinical field. However, fetal movement and blood flow through the maternal blood vessels can critically influence Doppler ultrasound signals. Moreover, CTG is not suitable for long-term monitoring. Therefore, researchers have been developing algorithms to estimate the FHR using electrocardiograms (ECGs) from the abdomen of pregnant women. However, separating the weak fetal ECG signal from the abdominal ECG signal is a challenging problem. In this paper, we propose a method for estimating the FHR using sequential total variation denoising and compare its performance with that of other single-channel fetal ECG extraction methods via simulation using the Fetal ECG Synthetic Database (FECGSYNDB). Moreover, we used real data from PhysioNet fetal ECG databases for the evaluation of the algorithm performance. The R-peak detection rate is calculated to evaluate the performance of our algorithm. Our approach could not only separate the fetal ECG signals from the abdominal ECG signals but also accurately estimate the FHR.

A novel LabVIEW-based multi-channel non-invasive abdominal maternal-fetal electrocardiogram signal generator

This paper describes the design, construction, and testing of a multi-channel fetal electrocardiogram (fECG) signal generator based on LabVIEW. Special attention is paid to the fetal heart development in relation to the fetus' anatomy, physiology, and pathology. The non-invasive signal generator enables many parameters to be set, including fetal heart rate (FHR), maternal heart rate (MHR), gestational age (GA), fECG interferences (biological and technical artifacts), as well as other fECG signal characteristics. Furthermore, based on the change in the FHR and in the T wave-to-QRS complex ratio (T/QRS), the generator enables manifestations of hypoxic states (hypoxemia, hypoxia, and asphyxia) to be monitored while complying with clinical recommendations for classifications in cardiotocography (CTG) and fECG ST segment analysis (STAN). The generator can also produce synthetic signals with defined properties for 6 input leads (4 abdominal and 2 thoracic). Such signals are well suited to the testing of new and existing methods of fECG processing and are effective in suppressing maternal ECG while non-invasively monitoring abdominal fECG. They may also contribute to the development of a new diagnostic method, which may be referred to as non-invasive trans-abdominal CTG +  STAN. The functional prototype is based on virtual instrumentation using the LabVIEW developmental environment and its associated data acquisition measurement cards (DAQmx). The generator also makes it possible to create synthetic signals and measure actual fetal and maternal ECGs by means of bioelectrodes.

Modeling quasi-periodic signals by a non-parametric model: application on fetal ECG extraction

Quasi-periodic signals can be modeled by their second order statistics as Gaussian process. This work presents a non-parametric method to model such signals. ECG, as a quasi-periodic signal, can also be modeled by such method which can help to extract the fetal ECG from the maternal ECG signal, using a single source abdominal channel. The prior information on the signal shape, and on the maternal and fetal RR interval, helps to better estimate the parameters while applying the Bayesian principles. The values of the parameters of the method, among which the R-peak instants, are accurately estimated using the Metropolis-Hastings algorithm. This estimation provides very precise values for the R-peaks, so that they can be located even between the existing time samples.

Fetal beat detection in abdominal ECG recordings: global and time adaptive approaches

We present a method for location of fetal QRS in maternal abdominal ECG recordings. This method's initial, global approach was proposed in the context of the 2013 PhysioNet/Computing in Cardiology Challenge where it was tested on the 447 four channel one-minute recordings.The first step is filtering to eliminate baseline wander and high frequency noise. Upon detection, maternal QRS is removed on each channel using a filter applied to the other three channels. Next we locate fetal QRS on each channel and select the channel with the best set of detections. The method was awarded the third-best score in the Challenge event 1 with 278.755 (beats/minute) and the fourth-best score on event 2 with 28.201 ms.The 5 min long recordings of the Abdominal and Direct Fetal ECG Database were used to further test the method. This database contains five recordings obtained from women in labor. Results in these longer recordings were not satisfactory. This appears to be particularly the case in recordings with a more clearly non-stationary nature. In a new approach to our method, some changes are introduced. Two features are updated over time: the filter used to eliminate maternal QRS and the channel used to detect fetal beats. These changes significantly improved the QRS detection performance on longer recordings, but the scores on the 1 minute Challenge recordings were degraded.