Abstract

Fetal movements (FM) are an important factor in the assessment of fetal health. However, there is currently no reliable way to monitor FM outside clinical environs. While extensive research has been carried out using accelerometer-based systems to monitor FM, the desired accuracy of detection is yet to be achieved. A major challenge has been the difficulty of testing and calibrating sensors at the pre-clinical stage. Little is known about fetal movement features, and clinical trials involving pregnant women can be expensive and ethically stringent. To address these issues, we introduce a novel FM simulator, which can be used to test responses of sensor arrays in a laboratory environment. The design uses a silicon-based membrane with material properties similar to that of a gravid abdomen to mimic the vibrations due to fetal kicks. The simulator incorporates mechanisms to pre-stretch the membrane and to produce kicks similar to that of a fetus. As a case study, we present results from a comparative study of an acoustic sensor, an accelerometer, and a piezoelectric diaphragm as candidate vibration sensors for a wearable FM monitor. We find that the acoustic sensor and the piezoelectric diaphragm are better equipped than the accelerometer to determine durations, intensities, and locations of kicks, as they have a significantly greater response to changes in these conditions than the accelerometer. Additionally, we demonstrate that the acoustic sensor and the piezoelectric diaphragm can detect weaker fetal movements (threshold wall displacements are less than 0.5 mm) compared to the accelerometer (threshold wall displacement is 1.5 mm) with a trade-off of higher power signal artefacts. Finally, we find that the piezoelectric diaphragm produces better signal-to-noise ratios compared to the other two sensors in most of the cases, making it a promising new candidate sensor for wearable FM monitors. We believe that the FM simulator represents a key development towards enabling the eventual translation of wearable FM monitoring garments.

Highlights

  • Monitoring of fetal movements (FM) has long been a subject of interest to medical and research communities due to the association between reduced Fetal movements (FM) and several fetal health conditions, such as fetal distress, placental dysfunction, fetal growth restriction, and hypoxia [1,2,3,4,5,6]

  • The piezoelectric diaphragm had the best signal-to-noise ratio (SNR) for most of the input conditions, which signifies its superiority in terms of the signal quality and makes it a promising candidate sensor for fetal movement monitors

  • This paper presents the most comprehensive attempt to simulate vibrations of a maternal abdomen due to fetal kicks in a laboratory set-up to date, fulfilling the unmet need for a pre-clinical facility for testing and calibration of vibration sensors for fetal movement (FM) monitors

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Summary

Introduction

Monitoring of fetal movements (FM) has long been a subject of interest to medical and research communities due to the association between reduced FM and several fetal health conditions, such as fetal distress, placental dysfunction, fetal growth restriction, and hypoxia [1,2,3,4,5,6]. A reduction in FM often provides an early warning of fetal health complications [7,8,9,10]. Another study on 161 singleton pregnancies resulting in stillbirths at Nottingham City Hospital from 1991 to 1997 stated that reductions in FM were reported in 54.7% of the cases [10]. A recent study on 409,175 pregnancies in the UK and Ireland found that the awareness of reduced FM through maternal sensation does not significantly reduce the risk of stillbirth [11], but this does not negate the value and impact of a method for objectively quantifying FM. The oldest and most commonly used method of quantifying FM is through maternal sensation

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