Abstract
The fetal Doppler Ultrasound (DUS) is commonly used for monitoring fetal heart rate and can also be used for identifying the event timings of fetal cardiac valve motions. In early-stage fetuses, the detected Doppler signal suffers from noise and signal loss due to the fetal movements and changing fetal location during the measurement procedure. The fetal cardiac intervals, which can be estimated by measuring the fetal cardiac event timings, are the most important markers of fetal development and well-being. To advance DUS-based fetal monitoring methods, several powerful and well-advanced signal processing and machine learning methods have recently been developed. This review provides an overview of the existing techniques used in fetal cardiac activity monitoring and a comprehensive survey on fetal cardiac Doppler signal processing frameworks. The review is structured with a focus on their shortcomings and advantages, which helps in understanding fetal Doppler cardiogram signal processing methods and the related Doppler signal analysis procedures by providing valuable clinical information. Finally, a set of recommendations are suggested for future research directions and the use of fetal cardiac Doppler signal analysis, processing, and modeling to address the underlying challenges.
Highlights
Fetal heart rate (FHR) monitoring has been extensively used to assess fetal well-being
The process of FHR monitoring is commonly used during prenatal screening to detect possible fetal health problems that may result in neurological damage or in some cases fetal death during labor
The current survey has discussed the importance of clinical FHR monitoring and provided a critical overview of the existing techniques
Summary
Fetal heart rate (FHR) monitoring has been extensively used to assess fetal well-being. A Doppler FHR monitor is a handheld ultrasound transducer used to detect the fetal heart beat during prenatal care This device uses the Doppler effect to provide an audible simulation of the heartbeat. A number of authors have designed a device that can simulate the fetal heart valves and cardiac wall motion in air This device can be used to test Doppler FHR monitoring in a clinical environment by using a modified electrical relay in air and generating a similar Doppler frequency shift to the fetal heart activity. The proposed technique for the FHR estimation on a beat-tobeat basis provided a high accuracy for the fetal heart interval measurement and enabled a reliable, accurate, and quantitative assessment of the FHR variability, while reducing the number of invalid cardiac cycle measurements. The PEP is a sensitive sign of the functional state of the fetal myocardium and becomes prolonged early in the development
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