A Combined Independent Source Separation and Quality Index Optimization Method for Fetal ECG Extraction from Abdominal Maternal Leads

Template subtraction based methods for non-invasive fetal electrocardiography extraction

Assessment of fetal heart rate (fHR) through non-invasive fetal electrocardiogram (fECG) is challenging task. This study compares the performance of five template subtraction (TS) methods on Labor (12 5-min recordings) and Pregnancy datasets (10 20-min recordings). The methods include TS without adaptation, TS using singular value decomposition (TS[Formula: see text]), TS using linear prediction (TS[Formula: see text]), TS using scaling factor (TS[Formula: see text]), and sequential analysis (SA). The influence of the chosen maternal wavelet for the continuous wavelet transform (CWT) detector is also compared. The F1 score was used to measure performance. Each recording in both datasets consisted of four signals, resulting in a total comparison of 88 signals for the TS-based methods. The study reported the following results: F1 = 95.71% with TS, F1 = 95.93% with TS[Formula: see text], F1 = 95.30% with TS[Formula: see text], F1 = 95.82% with TS[Formula: see text], and F1 = 95.99% with SA. The study identified gaus3 as the suitable maternal wavelet for fetal R-peak detection using the CWT detector. Furthermore, the study classified signals from the tested datasets into categories of high, medium, and low quality, providing valuable insights for subsequent fECG signal extraction. This research contributes to advancing the understanding of non-invasive fECG signal processing and lays the groundwork for improving fetal monitoring in clinical settings.

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.

Independent component analysis algorithms for non-invasive fetal electrocardiography

The independent component analysis (ICA) based methods are among the most prevalent techniques used for non-invasive fetal electrocardiogram (NI-fECG) processing. Often, these methods are combined with other methods, such adaptive algorithms. However, there are many variants of the ICA methods and it is not clear which one is the most suitable for this task. The goal of this study is to test and objectively evaluate 11 variants of ICA methods combined with an adaptive fast transversal filter (FTF) for the purpose of extracting the NI-fECG. The methods were tested on two datasets, Labour dataset and Pregnancy dataset, which contained real records obtained during clinical practice. The efficiency of the methods was evaluated from the perspective of determining the accuracy of detection of QRS complexes through the parameters of accuracy (ACC), sensitivity (SE), positive predictive value (PPV), and harmonic mean between SE and PPV (F1). The best results were achieved with a combination of FastICA and FTF, which yielded mean values of ACC = 83.72%, SE = 92.13%, PPV = 90.16%, and F1 = 91.14%. Time of calculation was also taken into consideration in the methods. Although FastICA was ranked to be the sixth fastest with its mean computation time of 0.452 s, it had the best ratio of performance and speed. The combination of FastICA and adaptive FTF filter turned out to be very promising. In addition, such device would require signals acquired from the abdominal area only; no need to acquire reference signal from the mother's chest.

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.

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.

[Fetal ECG extraction using temporal convolutional encoder-decoder network]

OBJECTIVE

To extract weak fetal ECG signals from mixed ECG signals recorded from maternal abdominal wall for accurate analysis of fetal heart rate and fetal ECG patterns.

METHODS

By exploiting the superior nonlinear mapping ability of deep convolutional network, we developed a nonlinear adaptive noise cancelling (nonlinear ANC) extraction framework based on a temporal convolutional encoder-decoder network for extracting fetal ECG signals. We first constructed a deep temporal convolutional network (TCED-Net) model for fetal ECG signal extraction, and with the maternal chest ECG signal as the reference signal, the maternal ECG component in the abdominal mixed signal was estimated using this model. The estimated maternal ECG component was subtracted from the mixed abdominal ECG signals to obtain the fetal ECG component. Experimental analyses were performed using synthetic ECG signals (FECGSYNDB) and clinical ECG signals (NIFECGDB, PCDB) to test the performance of the propose method.

RESULTS

The results of experiments on the FECGSYNDB dataset showed that the proposed approach achieved good performance in F₁-score (98.89%), mean-square-error (MSE; 0.20) and quality signalto-noise ratio (qSNR; 7.84). The F₁- score reached 99.1% on the NIFECGDB dataset and 98.61% on the PCDB dataset. The R peak detection accuracy index of the proposed method was higher than the existing best-performing algorithms such as EKF (F₁=93.84%), ES-RNN (F₁=97.20%) and AECG-DecompNet (F₁=95.43%) by 5.05%, 1.9% and 3.18%, respectively.

CONCLUSION

The fetal ECG signals extracted using the proposed method are clearer than those by the existing algorithms, suggesting the potential value this method for effective fetal health monitoring during pregnancy.

A comparative study of single-channel signal processing methods in fetal phonocardiography

Fetal phonocardiography is a non-invasive, completely passive and low-cost method based on sensing acoustic signals from the maternal abdomen. However, different types of interference are sensed along with the desired fetal phonocardiography. This study focuses on the comparison of fetal phonocardiography filtering using eight algorithms: Savitzky-Golay filter, finite impulse response filter, adaptive wavelet transform, maximal overlap discrete wavelet transform, variational mode decomposition, empirical mode decomposition, ensemble empirical mode decomposition, and complete ensemble empirical mode decomposition with adaptive noise. The effectiveness of those methods was tested on four types of interference (maternal sounds, movement artifacts, Gaussian noise, and ambient noise) and eleven combinations of these disturbances. The dataset was created using two synthetic records r01 and r02, where the record r02 was loaded with higher levels of interference than the record r01. The evaluation was performed using the objective parameters such as accuracy of the detection of S1 and S2 sounds, signal-to-noise ratio improvement, and mean error of heart interval measurement. According to all parameters, the best results were achieved using the complete ensemble empirical mode decomposition with adaptive noise method with average values of accuracy = 91.53% in the detection of S1 and accuracy = 68.89% in the detection of S2. The average value of signal-to-noise ratio improvement achieved by complete ensemble empirical mode decomposition with adaptive noise method was 9.75 dB and the average value of the mean error of heart interval measurement was 3.27 ms.

Heuristic RNN-based Kalman filter for fetal electrocardiogram extraction

Fetal Electrocardiogram (FECG) analysis helps in diagnosis of fetal heart. Extracting FECG from composite abdominal signal that contains noises like maternal ECG (MECG), electrical interference etc is a topic of great research interest, and several approaches have been reported. The proposed method is Heuristic RNN-based Kalman Filter for Fetal Electrocardiogram Extraction (HRKFFEE) which is based on redundant noise and signal patterns in the residual signal of FECG and MECG. Two functional blocks are used in the proposed method. The first functional block is based on Heuristic RNN equipped with legacy Long Short-Term Memory (LSTM) for assembling a knowledgebase and the second functional block is RNN-based Kalman filter. Upon testing, the proposed method delivers better average values of accuracy, F Score, Precision and Specificity as 93.118%, 93.106%, 92.9495 % and 92.98% respectively.

Music Modulates Autonomic Nervous System Activity in Human Fetuses

Context

Fetal Autonomic Nervous sysTem Evaluation (FANTE) is a non-invasive tool that evaluates the autonomic nervous system activity in a fetus. Autonomic nervous system maturation and development during prenatal life are pivotal for the survival and neuropsychiatric development of the baby.

Objective

Aim of the study is to evaluate the effect of music stimulation on fetal heart rate and specific parameters linked to ANS activity, in particular fetal heart rate variability.

Methods

Thirty-two women between the 32nd and 38th week with a singleton uncomplicated pregnancy were recruited. All FANTE data collections were acquired using a 10-derivation electrocardiograph placed on the maternal abdomen. In each session (5 min basal, 10 min with music stimulus, and 5 min post-stimulus), FANTE was registered. The music stimulus was “Clair de lune” Debussy, played through headphones on the mother’s abdomen (CTR: 31927).

Results

Music does not change the mean value of fetal heart rate. However, indices of total fetal heart rate variability statistically increase (RRsd p = 0.037, ANNsd p = 0.039, SD2 p = 0.019) during music stimulation in comparison to the basal phase. Heart rate variability increase depends mainly on the activation of parasympathetic branches (CVI p = 0.013), meanwhile, no significant changes from basal to stimulation phase were observed for indices of sympathetic activity. All the parameters of heart rate variability and parasympathetic activity remained activated in the post-stimulus phase compared to the stimulus phase. In the post-stimulus phase, sympathetic activity resulted in a significant reduction (LFn p = 0.037).

Conclusion

Music can influence the basal activity of the fetal autonomic nervous system, enhancing heart rate variability, without changing fetal heart rate mean value. Music is enabled to induce a relaxation state in a near-to-term fetus, mediated by parasympathetic activation and by a parallel sympathetic inhibition.

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).

Advanced Bioelectrical Signal Processing Methods: Past, Present and Future Approach-Part I: Cardiac Signals

Advanced signal processing methods are one of the fastest developing scientific and technical areas of biomedical engineering with increasing usage in current clinical practice. This paper presents an extensive literature review of the methods for the digital signal processing of cardiac bioelectrical signals that are commonly applied in today’s clinical practice. This work covers the definition of bioelectrical signals. It also covers to the extreme extent of classical and advanced approaches to the alleviation of noise contamination such as digital adaptive and non-adaptive filtering, signal decomposition methods based on blind source separation and wavelet transform.

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.

An Improved FastICA Method for Fetal ECG Extraction

Objective

The fast fixed-point algorithm for independent component analysis (FastICA) has been widely used in fetal electrocardiogram (ECG) extraction. However, the FastICA algorithm is sensitive to the initial weight vector, which affects the convergence of the algorithm. In order to solve this problem, an improved FastICA method was proposed to extract fetal ECG.

Methods

First, the maternal abdominal mixed signal was centralized and whitened, and the overrelaxation factor was incorporated into Newton's iterative algorithm to process the initial weight vector randomly generated. The improved FastICA algorithm was used to separate the source components, selected the best maternal ECG from the separated source components, and detected the R-wave location of the maternal ECG. Finally, the maternal ECG component in each channel was removed by the singular value decomposition (SVD) method to obtain a clean fetal ECG signal.

Results

An annotated clinical fetal ECG database was used to evaluate the improved algorithm and the conventional FastICA algorithm. The average number of iterations of the algorithm was reduced from 35 before the improvement to 13. Correspondingly, the average running time was reduced from 1.25 s to 1.04 s when using the improved algorithm. The signal-to-noise ratio (SNR) based on eigenvalues of the improved algorithm was 1.55, as compared to 0.99 of the conventional FastICA algorithm. The SNR based on cross-correlation coefficients of the conventional algorithm was also improved from 0.59 to 2.02. The sensitivity, positive predictive accuracy, and harmonic mean (F1) of the improved method were 99.37%, 99.00%, and 99.19%, respectively, while these metrics of the conventional FastICA method were 99.03%, 98.53%, and 98.78%, respectively.

Conclusions

The proposed improved FastICA algorithm based on the overrelaxation factor, while maintaining the rate of convergence, relaxes the requirement of initial weight vector, avoids the unbalanced convergence, reduces the number of iterations, and improves the convergence performance.