A Robust Approach Assisted by Signal Quality Assessment for Fetal Heart Rate Estimation from Doppler Ultrasound Signal.

Fetal heart rate (FHR) monitoring, typically using Doppler ultrasound (DUS) signals, is an important technique for assessing fetal health. In this work, we develop a robust DUS-based FHR estimation approach complemented by DUS signal quality assessment (SQA) based on unsupervised representation learning in response to the drawbacks of previous DUS-based FHR estimation and DUS SQA methods. We improve the existing FHR estimation algorithm based on the autocorrelation function (ACF), which is the most widely used method for estimating FHR from DUS signals. Short-time Fourier transform (STFT) serves as a signal pre-processing technique that allows the extraction of both temporal and spectral information. In addition, we utilize double ACF calculations, employing the first one to determine an appropriate window size and the second one to estimate the FHR within changing windows. This approach enhances the robustness and adaptability of the algorithm. Furthermore, we tackle the challenge of low-quality signals impacting FHR estimation by introducing a DUS SQA method based on unsupervised representation learning. We employ a variational autoencoder (VAE) to train representations of pre-processed fetal DUS data and aggregate them into a signal quality index (SQI) using a self-organizing map (SOM). By incorporating the SQI and Kalman filter (KF), we refine the estimated FHRs, minimizing errors in the estimation process. Experimental results demonstrate that our proposed approach outperforms conventional methods in terms of accuracy and robustness.

Unsupervised Learning-Based Non-Invasive Fetal ECG Muti-Level Signal Quality Assessment.

OBJECTIVE: To monitor fetal health and growth, fetal heart rate is a critical indicator. The non-invasive fetal electrocardiogram is a widely employed measurement for fetal heart rate estimation, which is extracted from the electrodes placed on the surface of the maternal abdomen. The qualities of the fetal ECG recordings, however, are frequently affected by the noises from various interference sources. In general, the fetal heart rate estimates are unreliable when low-quality fetal ECG signals are used for fetal heart rate estimation, which makes accurate fetal heart rate estimation a challenging task. So, the signal quality assessment for the fetal ECG records is an essential step before fetal heart rate estimation. In other words, some low-quality fetal ECG signal segments are supposed to be detected and removed by utilizing signal quality assessment, so as to improve the accuracy of fetal heart rate estimation. A few supervised learning-based fetal ECG signal quality assessment approaches have been introduced and shown to accurately classify high- and low-quality fetal ECG signal segments, but large fetal ECG datasets with quality annotation are required in these methods. Yet, the labeled fetal ECG datasets are limited. Proposed methods: An unsupervised learning-based multi-level fetal ECG signal quality assessment approach is proposed in this paper for identifying three levels of fetal ECG signal quality. We extracted some features associated with signal quality, including entropy-based features, statistical features, and ECG signal quality indices. Additionally, an autoencoder-based feature is calculated, which is related to the reconstruction error of the spectrograms generated from fetal ECG signal segments. The high-, medium-, and low-quality fetal ECG signal segments are classified by inputting these features into a self-organizing map. MAIN RESULTS: The experimental results showed that our proposal achieved a weighted average F1-score of 90% in three-level fetal ECG signal quality classification. Moreover, with the acceptable removal of detected low-quality signal segments, the errors of fetal heart rate estimation were reduced to a certain extent.

Non-invasive Fetal ECG Signal Quality Assessment based on Unsupervised Learning Approach.

The non-invasive fetal electrocardiogram (FECG) derived from abdominal surface electrodes has been widely used for fetal heart rate (FHR) monitoring to assess fetal well-being. However, the accuracy of FECG-based FHR estimation heavily depends on the quality of FECG signal itself, which can generally be affected by several interference sources such as maternal heart activities and fetal movements. Hence, FECG signal quality assessment (SQA) is an essential task to improve the accuracy of FHR estimation by removing or interpolating low-quality FECG signals. In recent research, various SQA methods based on supervised learning have been proposed. Although these methods could perform accurate SQA, they require large labeled datasets. Nevertheless, the labeled datasets for the FECG SQA are very limited. In this paper, to address this limitation, we propose an unsupervised learning-based SQA method for identifying high and low-quality FECG signal segments. Specifically, a fully convolutional network (FCN)-based autoencoder (AE) is trained for reconstructing a spectrogram derived from FECG. An AE-based feature related to reconstruction error is then calculated to identify high and low-quality FECG segments. In addition, entropy-based features, statistical features, and ECG signal quality indices (SQIs) are also extracted. The high and low-quality segments are identified by feeding the extracted features into self-organizing map (SOM). The experimental results showed that our proposal achieved an accuracy of 98% in high and low-quality signal classification.

An Autoencoder-Based Fetal Heart Rate Detector for Noninvasive Recordings.

Antenatal fetal health monitoring primarily depends on the signal analysis of abdominal or transabdominal electrocardiogram (ECG) recordings. The noninvasive approach for obtaining fetal heart rate (HR) reduces risks of potential infections and is convenient for the expectant mother. However, in addition to strong maternal ECG presence, undesirable signals due to body motion activity, muscle contractions, and certain bio-electric potentials degrade the diagnostic quality of obtained fetal ECG from abdominal ECG recordings. In this paper, we address this problem by proposing an improved framework for estimating fetal HR from non-invasively acquired abdominal ECG recordings. Since the most significant contamination is due to maternal ECG, in the proposed framework, we rely on neural network autoencoder for reconstructing maternal ECG. The autoencoder endeavors to establish the nonlinear mapping between abdominal ECG and maternal ECG thus preserving inherent fetal ECG artifacts. The framework is supplemented with an existing blind-source separation (BSS) algorithm for post-treatment of residual signals obtained after subtracting reconstructed maternal ECG from abdominal ECG. Furthermore, experimental assessments on clinically-acquired subjects' recordings advocate the effectiveness of the proposed framework in comparison with conventional techniques for maternal ECG removal.

Fetal Heart Rate Detection Using First Derivative of ECG Waveform and Multiple Weighting Functions.

Fetal heart rate monitoring using the abdominal electrocardiograph (ECG) is an important topic for the diagnosis of heart defects. Many studies on fetal heart rate detection have been presented, however, their accuracy is still unsatisfactory. That is because the fetal ECG waveform is contaminated by maternal ECG interference, muscle contractions, and motion artifacts. One of the conventional methods is to detect the R-peaks from the integrated power of the frequency corresponding to the fetal heartbeats. However, the detection accuracy of the R-peaks is not enough. In this paper, we propose a method to generate the candidates of R-peaks using the first derivative of the signal and to pick up the estimated heartbeats by a multiple weighting function. The proposed multiple weighting function is designed by the Gaussian distribution, of which parameters are set from a grid search with the goal of minimizing the standard deviation of RR intervals (neighboring R-peaks intervals). The validation for the proposed framework has been evaluated on real-world data, which got the better accuracy than the conventional method that detects R-peaks from the integrated power and uses the weighting function produced by a fixed parameter of Gaussian distribution [12]. The averaged absolute error (AAE) which compares the estimated fetal heart rate and the reference fetal heart rate has been decreased by 17.528 bpm.

Joint Multiple Subspace-based BSS Method for Fetal Heart Rate Extraction from Non-invasive Recordings.

Despite the enormous potential applications, non-invasive recordings have not yet made enough satisfaction for fetal disease detection. This is mainly due to the fetal ECG signal is contaminated by the maternal electrocardiograph (ECG) interference, muscle contractions, and motion artifacts. In this paper, we propose a joint multiple subspace-based blind source separation (BSS) approach to extract the fetal heart rate (HR), so that it could greatly reduce the effect of maternal ECG and motion artifacts. The approach relies on the estimation of the coefficient matrix formulated as the tensor decomposition in terms of multiple datasets. Since the objective function takes the coupling information from the stacking of the covariance matrix for multiple datasets into account, estimating the coefficient matrices is fulfilled not only on dependence across multiple datasets, but also can combine the extracted components across four different datasets. Numerical results demonstrate that the proposed method can achieve a high extracted HR accuracy for each dataset, when compared to some conventional methods.

Successful detection of the fetal electrocardiogram waveform changes during various states of singletons.

Accurate assessment of fetal well-being is one of the most important tasks for obstetricians. It is still difficult to measure fetal electrocardiogram (ECG) during fetal movements. Recently, a new method, blind source separation with reference signals, was proposed for stable measurements. This method distinguishes weak signals from noisy mixed signals with little information about the sources. The aim of this study is to estimate the ability of this method for fetal ECG monitoring and to establish standard fetal ECG electrocardiogram values of normal singletons including during fetal movement. The subjects enrolled were 167 pregnant women with normal single pregnancy from 18- to 41-week gestation, who regularly visited Tohoku University Hospital, and 12 pregnant women with fetal abnormality. Fetal signals were successfully separated in 163 of 179 subjects at 91.1% success rate regardless of fetal movements. Time intervals of ECG (P, PR and QRS intervals and QTc) were measured. The standard curves of each interval through the gestational period were obtained. The data in active phase were compared to that in rest phase and the data obtained from normal and abnormal fetuses were investigated. PR intervals in the rest phase were prolonged compared to those in the active phase. Fetal ECG showed anomalous values such as PR interval or QTc prolongation in the abnormal fetuses. The fetal ECG was measured by the new method with or without fetal movements, and the standard fetal ECG values have been established. This study provides a foundation for further detailed clinical studies.