Abstract

In this paper, a robust method of feto-maternal heart rate extraction from the non-invasive composite abdominal Electrocardiogram (aECG) signal is presented. The proposed method is based on the Complete Ensemble Empirical Mode Decomposition with Adaptive Noise (CEEMDAN) method, in which a composite aECG signal is decomposed into its constituent frequency components called Intrinsic Mode Functions (IMFs) or simply “modes”, with better spectral separation. Decomposed IMFs are then selected manually according to probable maternal and fetal heart rate information and are processed further for quantification of maternal and fetal heart rate and variability analysis. The proposed method was applied to aECG recordings collected from three different sources: (i) the PhysioNet (adfecgdb) database; (ii) the PhysioNet (nifecgdb) database; and (iii) synthetic aECG signal generated from mathematical modeling in the LabVIEW software environment. An overall sensitivity of 98.83%, positive diagnostic value of 97.97%, accuracy of 96.93% and performance index of 96.75% were obtained in the case of Maternal Heart Rate (MHR) quantification, and an overall sensitivity of 98.13%, positive diagnostic value of 97.62%, accuracy of 95.91% and performance index of 95.69% were obtained in case of Fetal Heart Rate (FHR) quantification. The obtained results confirm that CEEMDAN is a very robust and accurate method for extraction of feto-maternal heart rate components from aECG signals. We also conclude that non-invasive aECG is an effective and reliable method for long-term FHR and MHR monitoring during pregnancy and labor. The requirement of manual intervention while selecting the probable maternal and fetal components from “n” number of decomposed modes limits the real-time application of the proposed methodology. This is due to the fact that the number of modes “n” produced by the CEEMDAN decomposition is unpredictable. However, the proposed methodology is well suited for applications where a small time-delay or offset in feto-maternal monitoring can be acceptable. In future, application-specific modification of the CEEMDAN algorithm can be implemented to eliminate manual intervention completely and will be suitable for long-term feto-maternal monitoring.

Highlights

  • Electronic Fetal Monitoring (EFM) is an essential requirement when assessing the health state of the fetus and its overall growth and development inside the uterus during pregnancy and labor [1]

  • We have used the PhysioNet abdominal ECG (aECG) dataset, as well as the synthetic aECG dataset to evaluate the performance of CEEMDAN for the process of maternal and fetal heart rate extraction from a composite aECG signal

  • Long-term Fetal Heart Rate (FHR) monitoring is crucial in high-risk pregnancies, which can be accomplished only by a non-invasive method like aECG

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Summary

Introduction

Electronic Fetal Monitoring (EFM) is an essential requirement when assessing the health state of the fetus and its overall growth and development inside the uterus during pregnancy and labor [1]. In high-risk conditions like an Intra-Uterine Growth Retarded (IUGR) fetus or pregnancies complicated by pathologies like diabetes, infections, pre-eclampsia or placental abruption, etc., long-term fetal monitoring is required [2]. CTG is not suitable for long-term monitoring and requires highly experienced medical personnel for the interpretation of FHR traces. Fetal scalp Electrocardiogram (ECG) recordings are considered to be the gold standard in FHR monitoring, but can only be applied when the membrane has been ruptured [4]. Considering the above limitations, a non-invasive alternative for FHR monitoring is abdominal ECG (aECG) recordings. In the aECG method, electrodes are placed on the mother’s abdomen, which acquire a composite ECG signal, which consists of both fetal ECG (fECG) and maternal

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