Electrohysterogram Signals Research Articles

Recurrence quantification analysis of uterine vectormyometriogram reveals differences between normal-weight and overweight parturient women

Objective.This study aims to use recurrence quantification analysis (RQA) of uterine vectormyometriogram (VMG) created from the slow wave (SW) and high wave (HW) bands of electrohysterogram (EHG) signals and assess the directionality of the EHG activity (horizontal orX, vertical orY) in normal-weight (NW) and overweight (OW) women during the first stage of labor.Approach. The study involved 41 parturient women (NW = 21 and OW = 20) during the first stage of labor, all of whom were attended at the Gynecology and Obstetrics Hospital of the Maternal and Child Institute of the State of Mexico in Toluca, Mexico. Twenty-minute EHG signals were analyzed in horizontal and vertical directions. Linear and nonlinear indices such as dominant frequency (Dom), Sample Entropy (SampEn), and RQA measures of VMG were computed for SW and HW bands.Main results. Significant differences in SampEn and Dom were observed in the SW band between NW and OW in bothXandYdirections, indicating more regular dynamics of electrical uterine activity and a higher Dom in NW parturient women compared to OW women. Additionally, the RQA indices calculated from the VMG of SW were consistent and revealed that NW women exhibit more regular dynamics compared to OW women.Significance. The study demonstrates that RQA of VMG signals and EHG directionality differentiate uterine activity between NW and OW women during the first stage of labor. These findings suggest that the uterine vector may become more periodic, predictable, and stable in NW women compared to OW women. This highlights the importance of tailored clinical strategies for managing labor in OW women to improve maternal and infant outcomes.

Peak amplitude of the normalized power spectrum of the electromyogram of the uterus in the low frequency band is an effective predictor of premature birth.

The current trends in the development of methods for non-invasive prediction of premature birth based on the electromyogram of the uterus, i.e., electrohysterogram (EHG), suggest an ever-increasing use of large number of features, complex models, and deep learning approaches. These "black-box" approaches rarely provide insights into the underlying physiological mechanisms and are not easily explainable, which may prevent their use in clinical practice. Alternatively, simple methods using meaningful features, preferably using a single feature (biomarker), are highly desirable for assessing the danger of premature birth. To identify suitable biomarker candidates, we performed feature selection using the stabilized sequential-forward feature-selection method employing learning and validation sets, and using multiple standard classifiers and multiple sets of the most widely used features derived from EHG signals. The most promising single feature to classify between premature EHG records and EHG records of all other term delivery modes evaluated on the test sets appears to be Peak Amplitude of the normalized power spectrum (PA) of the EHG signal in the low frequency band (0.125-0.575 Hz) which closely matches the known Fast Wave Low (FWL) frequency band. For classification of EHG records of the publicly available TPEHG DB, TPEHGT DS, and ICEHG DS databases, using the Partition-Synthesis evaluation technique, the proposed single feature, PA, achieved Classification Accuracy (CA) of 76.5% (AUC of 0.81). In combination with the second most promising feature, Median Frequency (MF) of the power spectrum in the frequency band above 1.0 Hz, which relates to the maternal resting heart rate, CA increased to 78.0% (AUC of 0.86). The developed method in this study for the prediction of premature birth outperforms single-feature and many multi-feature methods based on the EHG, and existing non-invasive chemical and molecular biomarkers. The developed method is fully automatic, simple, and the two proposed features are explainable.

ANALYSIS OF ELECTROHYSTEROGRAM SIGNALS AND PREDICTION OF PRETERM BIRTHS USING MACHINE LEARNING

The World Health Organization (WHO) estimates that over 15 million infants are born before the entire period of pregnancy. Over a million neonatal deaths occurred in 2015 as a result of preterm delivery, which is the prime cause for most deaths among children under the age of five. Although preterm birth has no hereditary link, only 10% of preterm deliveries in high-income settings result in deaths, compared to a mortality rate of up to 90% in low-income nations. When preterm cases are discovered, in addition to enhanced care provided at home for the expecting mother, the growing foetus may also benefit from medication, hospitalization for the duration of the pregnancy, or both. Low-income countries also struggle with a lack of access to a comprehensive healthcare system, which makes it difficult to proactively detect premature births. Machine learning techniques have a great potential to improve this situation by providing an intelligent framework for the detection of critical situations and consequently alerting the individual in cases of anomalies. This will require further follow-up with medical specialists. In this work, we investigate the application of deep learning and machine learning techniques for the analysis of electrohysterogram (EHG) data, which are uterine electrical impulses used to detect preterm deliveries. The TPEHG dataset is used to train a variety of machine learning classifiers, such as Support Vector Machines, Logistic Regression, and Decision Trees, as well as Deep Neural Networks like Convolutional Neural Networks and LSTMs. Additionally, we use plurality voting to build an ensemble of various neural networks and binary classifiers that are trained to classify EHG signals. The ensemble machine learning classifier with five base classifiers produced the best results overall, with an accuracy of 98.99%, sensitivity of 98.3%, and specificity of 97.9% outperforming several state-of-the-art algorithms for preterm birth detection.

Prediction of Preterm Labor from the Electrohysterogram Signals Based on Different Gestational Weeks.

Timely preterm labor prediction plays an important role for increasing the chance of neonate survival, the mother's mental health, and reducing financial burdens imposed on the family. The objective of this study is to propose a method for the reliable prediction of preterm labor from the electrohysterogram (EHG) signals based on different pregnancy weeks. In this paper, EHG signals recorded from 300 subjects were split into 2 groups: (I) those with preterm and term labor EHG data that were recorded prior to the 26th week of pregnancy (referred to as the PE-TE group), and (II) those with preterm and term labor EHG data that were recorded after the 26th week of pregnancy (referred to as the PL-TL group). After decomposing each EHG signal into four intrinsic mode functions (IMFs) by empirical mode decomposition (EMD), several linear and nonlinear features were extracted. Then, a self-adaptive synthetic over-sampling method was used to balance the feature vector for each group. Finally, a feature selection method was performed and the prominent ones were fed to different classifiers for discriminating between term and preterm labor. For both groups, the AdaBoost classifier achieved the best results with a mean accuracy, sensitivity, specificity, and area under the curve (AUC) of 95%, 92%, 97%, and 0.99 for the PE-TE group and a mean accuracy, sensitivity, specificity, and AUC of 93%, 90%, 94%, and 0.98 for the PL-TL group. The similarity between the obtained results indicates the feasibility of the proposed method for the prediction of preterm labor based on different pregnancy weeks.

An automatic classification approach for preterm delivery detection based on deep learning

Recently, tocography (TOCO) and electrohysterogram (EHG) signals are real-time and non-invasive technology that has been applied to detect preterm delivery. This paper proposes a novel deep learning (DL) framework for automatically detecting preterm delivery based on EHG data. Initially, the recorded EHG signal, which corresponds to the electrical activity of the uterine muscles, is pre-processed using a 4th-order Butterworth filter and 6th-order Daubechies wavelet transform for filtering and denoising. Then, the pre-processed signal is employed for the feature extraction stage, mainly to extract the significant features specifically, median frequency, peak frequency, sample entropy, spectral entropy, power spectral density (PSD), fuzzy entropy, root mean square (RMS), and Shannon entropy. Next, the classification is performed using a two-step scheme called a circle-optimized bidirectional long short-term gated recurrent model (CoBi-LSTGR) to learn the extracted features. Here, the extracted features are initially fed to the bidirectional short-term memory (Bi-LSTM) and then provided to the bidirectional gated recurrent unit (Bi-GRU) model for more precise learning. At last, the learned features are used to classify the EHG signal into term and preterm. Subsequently, the hyperparameter tuning in both the learning models is done using the circle-inspired optimization algorithm (CiOA). The proposed framework is implemented in the Python platform and evaluates various performance metrics to validate the competence of a proposed scheme by employing the Term-Preterm EHG (TPEHG) database. The accuracy attained by a proposed for channels I, II, and III are found to be 99.09%, 99.01% and 99.89%, respectively. The experimental outcomes show that the proposed framework performs better against existing classifiers.

Enhancing classification of preterm-term birth using continuous wavelet transform and entropy-based methods of electrohysterogram signals.

Despite vast research, premature birth's electrophysiological mechanisms are not fully understood. Prediction of preterm birth contributes to child survival by providing timely and skilled care to both mother and child. Electrohysterography is an affordable, noninvasive technique that has been highly sensitive in diagnosing preterm labor. This study aimed to choose the more appropriate combination of characteristics, such as electrode channel and bandwidth, as well as those linear, time-frequency, and nonlinear features of the electrohysterogram (EHG) for predicting preterm birth using classifiers. We analyzed two open-access datasets of 30 minutes of EHG obtained in regular checkups of women around 31 weeks of pregnancy who experienced premature labor (P) and term labor (T). The current approach filtered the raw EHGs in three relevant frequency subbands (0.3-1 Hz, 1-2 Hz, and 2-3Hz). The EHG time series were then segmented to create 120-second windows, from which individual characteristics were calculated. The linear, time-frequency, and nonlinear indices of EHG of each combination (channel-filter) were fed to different classifiers using feature selection techniques. The best performance, i.e., 88.52% accuracy, 83.83% sensitivity, and 93.22% specificity, was obtained in the 2-3 Hz bands using Medium Frequency, Continuous Wavelet Transform (CWT), and entropy-based indices. Interestingly, CWT features were significantly different in all filter-channel combinations. The proposed study uses small samples of EHG signals to diagnose preterm birth accurately, showing their potential application in the clinical environment. Our results suggest that CWT and novel entropy-based features of EHG could be suitable descriptors for analyzing and understanding the complex nature of preterm labor mechanisms.

N-Beats as an EHG Signal Forecasting Method for Labour Prediction in Full Term Pregnancy

The early prediction of onset labour is critical for avoiding the risk of death due to pregnancy delay. Low-income countries often struggle to deliver timely service to pregnant women due to a lack of infrastructure and healthcare facilities, resulting in pregnancy complications and, eventually, death. In this regard, several artificial-intelligence-based methods have been proposed based on the detection of contractions using electrohysterogram (EHG) signals. However, the forecasting of pregnancy contractions based on real-time EHG signals is a challenging task. This study proposes a novel model based on neural basis expansion analysis for interpretable time series (N-BEATS) which predicts labour based on EHG forecasting and contraction classification over a given time horizon. The publicly available TPEHG database of Physiobank was exploited in order to train and test the model, where signals from full-term pregnant women and signals recorded after 26 weeks of gestation were collected. For these signals, the 30 most commonly used classification parameters in the literature were calculated, and principal component analysis (PCA) was utilized to select the 15 most representative parameters (all the domains combined). The results show that neural basis expansion analysis for interpretable time series (N-BEATS) forecasting can forecast EHG signals through training after few iterations. Similarly, the forecasting signal’s duration is determined by the length of the recordings. We then deployed XG-Boost, which achieved the classification accuracy of 99 percent, outperforming the state-of-the-art approaches using a number of classification features greater than or equal to 15.

Novel uterine contraction signals decomposition for enhanced preterm and birth imminency prediction

• Application of an Intelligent System to tackle a global epidemic as declared by the World Health Organisation • Use of an Intelligent system in Obstetric Medicine • Metaheuristic based signal decomposition for greater prediction accuracy • Explainable Decision Support model Preterm births are one of the key causes of death in children under the age of five: they have financial implications associated with care and cause great psychological distress for the families involved. In this work, we applied a novel signal decomposition approach termed Linear Series Decomposition Learner (LSDL) from electrohysterogram (EHG) and tocodynamometer (Toco) signals to the prediction of a preterm delivery, alongside an associated delivery imminency timeline, using the logistic regression and support vector machine classifiers. The results from the classification exercise showed an equivalent performance for the EHG and Toco signals for the preterm prediction, while in the case of the imminency prediction, the Toco signals provided better results in predicting the delivery imminency period. These results have made apparent that a LSDL decomposed Toco/mechanical signal carries useful information which can be used to predict delivery imminency and supersedes that of an electrophysiological/EHG signal.

Characterization and separation of preterm and term spontaneous, induced, and cesarean EHG records

To improve the understanding of the underlying physiological processes that lead to preterm birth, and different term delivery modes, we quantitatively characterized and assessed the separability of the sets of early (23rd week) and later (31st week) recorded, preterm and term spontaneous, induced, cesarean, and induced-cesarean electrohysterogram (EHG) records using several of the most widely used non-linear features extracted from the EHG signals. Linearly modeled temporal trends of the means of the median frequencies (MFs), and of the means of the peak amplitudes (PAs) of the normalized power spectra of the EHG signals, along pregnancy (from early to later recorded records), derived from a variety of frequency bands, revealed that for the preterm group of records, in comparison to all other term delivery groups, the frequency spectrum of the frequency band B0L (0.08–0.3 Hz) shifts toward higher frequencies, and that the spectrum of the newly identified frequency band B0L’ (0.125–0.575 Hz), which approximately matches the Fast Wave Low band, becomes stronger. The most promising features to separate between the later preterm group and all other later term delivery groups appear to be MF (p=1.1⋅10−5) in the band B0L of the horizontal signal S3, and PA (p=2.4⋅10−8) in the band B0L’ (S3). Moreover, the PA in the band B0L’ (S3) showed the highest power to individually separate between the later preterm group and any other later term delivery group. Furthermore, the results suggest that in preterm pregnancies the resting maternal heart rate decreases between the 23rd and 31st week of gestation.

Network Theory Based EHG Signal Analysis and its Application in Preterm Prediction.

Preterm birth is the leading cause of neonatal morbidity and mortality. Early identification of high-risk patients followed by medical interventions is essential to the prevention of preterm birth. Based on the relationship between uterine contraction and the fundamental electrical activities of muscles, we extracted effective features from EHG signals recorded from pregnant women, and use them to train classifiers with the purpose of providing high precision in classifying term and preterm pregnancies. To characterize changes from irregularity to coherence of the uterine activity during the whole pregnancy, network representations of the original electrohysterogram (EHG) signals are established by applying the Horizontal Visibility Graph (HVG) algorithm, from which we extract network degree density and distribution, clustering coefficient and assortativity coefficient. Concerns on the interferences of different noise sources embedded in the EHG signal, we apply Short-Time Fourier Transform (STFT) to expand the original signal in the time-frequency domain. This allows a network representation and the extraction of related features on each frequency component. Feature selection algorithms are then used to filter out unrelated frequency components. We further apply the proposed feature extraction method to EHG signals available in the Term-Preterm EHG database (TPEHG), and use them to train classifiers. We adopt the Partition-Synthesis scheme which splits the original imbalanced dataset into two sets, and synthesizes artificial samples separately within each subset to solve the problem of dataset imbalance. The optimally selected network-based features, not only contribute to the identification of the essential frequency components of uterine activities related to preterm birth, but also to improved performance in classifying term/preterm pregnancies, i.e., the SVM (Support Vector Machine) classifier trained with the available samples in the TPEHG gives sensitivity, specificity, overall accuracy, and auc values as high as 0.89, 0.93, 0.91, and 0.97, respectively.

Regional identification of information flow termination of electrohysterographic signals: Towards understanding human uterine electrical propagation

Background and Objective: The uterine electrohysterogram (EHG) contains important information about electrical signal propagation which may be useful to monitor and predict the progress of pregnancy towards parturition. Directed information processing has the potential to be of use in studying EHG recordings. However, so far, there is no directed information-based estimation scheme that has been applied to investigating the propagation of human EHG recordings. To realize this, the approach of directed information and its reliability and adaptability should be scientifically studied.Methods: We demonstrated an estimation scheme of directed information to identify the spatiotemporal relationship between the recording channels of EHG signal and assess the algorithm reliability initially using simulated data. Further, a regional identification of information flow termination (RIIFT) approach was developed and applied for the first time to extant multichannel EHG signals to reveal the terminal zone of propagation of the electrical activity associated with uterine contraction. RIIFT operates by estimating the pairwise directed information between neighboring EHG channels and identifying the location where there is the strongest inward flow of information. The method was then applied to publicly-available experimental data obtained from pregnant women with the use of electrodes arranged in a 4−by−4 grid.Results: Our results are consistent with the suggestions from the previous studies with the added identification of preferential sites of excitation termination - within the estimated area, the direction of surface action potential propagation towards the medial axis of uterus during contraction was discovered for 72.15% of the total cases, demonstrating that our RIIFT method is a potential tool to investigate EHG propagation for advancing our understanding human uterine excitability.Conclusions: We developed a new approach and applied it to multichannel human EHG recordings to investigate the electrical signal propagation involved in uterine contraction. This provides an important platform for future studies to fill knowledge gaps in the spatiotemporal patterns of electrical excitation of the human uterus.

Assessment of Features between Multichannel Electrohysterogram for Differentiation of Labors.

Electrohysterogram (EHG) is a promising method for noninvasive monitoring of uterine electrical activity. The main purpose of this study was to characterize the multichannel EHG signals to distinguish between term delivery and preterm birth, as well as deliveries within and beyond 24 h. A total of 219 pregnant women were grouped in two ways: (1) term delivery (TD), threatened preterm labor (TPL) with the outcome of preterm birth (TPL_PB), and TPL with the outcome of term delivery (TPL_TD); (2) EHG recording time to delivery (TTD) ≤ 24 h and TTD > 24 h. Three bipolar EHG signals were analyzed for the 30 min recording. Six EHG features between multiple channels, including multivariate sample entropy, mutual information, correlation coefficient, coherence, direct partial Granger causality, and direct transfer entropy, were extracted to characterize the coupling and information flow between channels. Significant differences were found for these six features between TPL and TD, and between TTD ≤ 24 h and TTD > 24 h. No significant difference was found between TPL_PB and TPL_TD. The results indicated that EHG signals of TD were more regular and synchronized than TPL, and stronger coupling between multichannel EHG signals was exhibited as delivery approaches. In addition, EHG signals propagate downward for the majority of pregnant women regardless of different labors. In conclusion, the coupling and propagation features extracted from multichannel EHG signals could be used to differentiate term delivery and preterm birth and may predict delivery within and beyond 24 h.

Comparison of wavelet‐based decomposition and empirical mode decomposition of electrohysterogram signals for preterm birth classification

Signal decomposition is a computational technique that dissects a signal into its constituent components, providing supplementary information. In this study, the capability of two common signal decomposition techniques, including wavelet-based and empirical mode decomposition, on preterm birth classification was investigated. Ten time-domain features were extracted from the constituent components of electrohysterogram (EHG) signals, including EHG subbands and EHG intrinsic mode functions, and employed for preterm birth classification. Preterm birth classification and anticipation are crucial tasks that can help reduce preterm birth complications. The computational results show that the preterm birth classification obtained using wavelet-based decomposition is superior. This, therefore, implies that EHG subbands decomposed through wavelet-based decomposition provide more applicable information for preterm birth classification. Furthermore, an accuracy of 0.9776 and a specificity of 0.9978, the best performance on preterm birth classification among state-of-the-art signal processing techniques, were obtained using the time-domain features of EHG subbands.

Prediction of Preterm Delivery from Unbalanced EHG Database.

Objective: The early prediction of preterm labor can significantly minimize premature delivery complications for both the mother and infant. The aim of this research is to propose an automatic algorithm for the prediction of preterm labor using a single electrohysterogram (EHG) signal. Method: The proposed method firstly employs empirical mode decomposition (EMD) to split the EHG signal into two intrinsic mode functions (IMFs), then extracts sample entropy (SampEn), the root mean square (RMS), and the mean Teager–Kaiser energy (MTKE) from each IMF to form the feature vector. Finally, the extracted features are fed to a k-nearest neighbors (kNN), support vector machine (SVM), and decision tree (DT) classifiers to predict whether the recorded EHG signal refers to the preterm case. Main results: The studied database consists of 262 term and 38 preterm delivery pregnancies, each with three EHG channels, recorded for 30 min. The SVM with a polynomial kernel achieved the best result, with an average sensitivity of 99.5%, a specificity of 99.7%, and an accuracy of 99.7%. This was followed by DT, with a mean sensitivity of 100%, a specificity of 98.4%, and an accuracy of 98.7%. Significance: The main superiority of the proposed method over the state-of-the-art algorithms that studied the same database is the use of only a single EHG channel without using either synthetic data generation or feature ranking algorithms.

Premature Birth Detection from EHG signals

Premature birth is one of the major problems worldwide. Different methods have been researched and used to detect preterm birth from past to present. The most commonly used ones are; The tocodynamometer device is Transvaginal Cervix Length, Bishop Score and ElectroHysteroGram (EHG) signal. Studies have shown that it is widely used in estimating the risk of preterm birth using EHG signals. In the studies, feature extraction was made from EHG signals and preterm birth risk was estimated with various regression algorithms. In this study, the SMOTE algorithm in the methods used in the detection of preterm birth with EHG signals was examined and compared. As a result, it has been seen that the SMOTE algorithm is effective in reaching the result in all methods. In this study, the best result was obtained with the CNN algorithm

Realistic preterm prediction based on optimized synthetic sampling of EHG signal

Preterm labor is the leading cause of neonatal morbidity and mortality in newborns and has attracted significant research attention from many scientific areas. The relationship between uterine contraction and the underlying electrical activities makes uterine electrohysterogram (EHG) a promising direction for detecting and predicting preterm births. However, due to the scarcity of EHG signals, especially those leading to preterm births, synthetic algorithms have been used to generate artificial samples of preterm birth type in order to eliminate bias in the prediction towards normal delivery, at the expense of reducing the feature effectiveness in automatic preterm detection based on machine learning. To address this problem, we quantify the effect of synthetic samples (balance coefficient) on the effectiveness of features and form a general performance metric by using several feature scores with relevant weights that describe their contributions to class segregation. In combination with the activation/inactivation functions that characterize the effect of the abundance of training samples on the accuracy of the prediction of preterm and normal birth delivery, we obtained an optimal sample balance coefficient that compromises the effect of synthetic samples in removing bias toward the majority group (i.e., normal delivery and the side effect of reducing the importance of features). A more realistic predictive accuracy was achieved through a series of numerical tests on the publicly available TPEHG database, therefore demonstrating the effectiveness of the proposed method.

Performance comparison of coupling-evaluation methods in discriminating between pregnancy and labor EHG signals

BackgroundRecent years have seen an increased interest in electrohysterogram (EHG) signals as a means to evaluate the synchronization of uterine contractions. Several studies have pointed out that the quality of signal processing – and hence the interpretation of measurement results – is affected significantly by the choice of measurement technique and the presence of non-stationary frequency content in EHG signals. To our knowledge, the effect of time variance on the quality of EHG signal processing has never been fully investigated. How best to process EHG signals with the goal of distinguishing labor-induced contractions from their harmless, pre-labor cousins, remains an open question. MethodOur methodology is based on three pillars. The first consists of a new method for EHG preprocessing in which we apply a second-order Butterworth filter to retain only the EHG fast-wave, low-frequency band (FWL), then use a bivariate piecewise stationary pre-segmentation (bPSP) algorithm to segment the EHG signal into stationary parts. The second pillar addresses the estimation of connectivity and directionality using three methods: nonlinear correlation coefficient (h2), general synchronization (H), and Granger causality (GC). The third pillar is related to signal classification and discrimination between pregnancy and labor using receiver operating curves (ROC) and connectivity and direction maps. For this purpose, we analyze the impact of four factors on data processing efficiency: i) method of connectivity detection, ii) effect of piecewise stationary segmentation preprocessing, iii) retained frequency content and iv) electrode configuration used for EHG recording (bipolar vs. unipolar). ResultsOur results show that piecewise signal segmentation and filtering considerably improves classification performance and statistical significance for some connectivity methods, in particular the h2. To this end we propose a new approach (detailed below) for h2 called Filtered-Windowed (FW) h2 that better highlights the differences between pregnancy and labor in the connectivity matrix and directionality maps. ConclusionsThis is the first comparative study of the effects of multiple processing factors on connectivity measurement efficiency. Our results indicate that appropriate preprocessing can improve the differentiation of pregnancy and labor-induced contraction signals and may lead to innovative applications in the prevention of preterm labor.

Machine Learning Methods for Preterm Birth Prediction: A Review

Preterm births affect around 15 million children a year worldwide. Current medical efforts focus on mitigating the effects of prematurity, not on preventing it. Diagnostic methods are based on parent traits and transvaginal ultrasound, during which the length of the cervix is examined. Approximately 30% of preterm births are not correctly predicted due to the complexity of this process and its subjective assessment. Based on recent research, there is hope that machine learning can be a helpful tool to support the diagnosis of preterm births. The objective of this study is to present various machine learning algorithms applied to preterm birth prediction. The wide spectrum of analysed data sets is the advantage of this survey. They range from electrohysterogram signals through electronic health records to transvaginal ultrasounds. Reviews of works on preterm birth already exist; however, this is the first review that includes works that are based on a transvaginal ultrasound examination. In this work, we present a critical appraisal of popular methods that have employed machine learning methods for preterm birth prediction. Moreover, we summarise the most common challenges incurred and discuss their possible application in the future.

Automatic recognition of uterine contractions with electrohysterogram signals based on the zero-crossing rate

Uterine contraction (UC) is an essential clinical indicator in the progress of labour and delivery. Electrohysterogram (EHG) signals recorded on the abdomen of pregnant women reflect the uterine electrical activity. This study proposes a novel algorithm for automatic recognition of UCs with EHG signals to improve the accuracy of detecting UCs. EHG signals by electrodes, the tension of the abdominal wall by tocodynamometry (TOCO) and maternal perception were recorded simultaneously in 54 pregnant women. The zero-crossing rate (ZCR) of the EHG signal and its power were calculated to modulate the raw EHG signal and highlight the EHG bursts. Then the envelope was extracted from the modulated EHG for UC recognition. Besides, UC was also detected by the conventional TOCO signal. Taking maternal perception as a reference, the UCs recognized by EHG and TOCO were evaluated with the sensitivity, positive predictive value (PPV), and UC parameters. The results show that the sensitivity and PPV are 87.8% and 93.18% for EHG, and 84.04% and 90.89% for TOCO. EHG detected a larger number of UCs than TOCO, which is closer to maternal perception. The duration and frequency of UC obtained from EHG and TOCO were not significantly different (p > 0.05). In conclusion, the proposed UC recognition algorithm has high accuracy and simple calculation which could be used for real-time analysis of EHG signals and long-term monitoring of UCs.

Assessing Velocity and Directionality of Uterine Electrical Activity for Preterm Birth Prediction Using EHG Surface Records.

The aim of the present study was to assess the capability of conduction velocity amplitudes and directions of propagation of electrohysterogram (EHG) waves to better distinguish between preterm and term EHG surface records. Using short-time cross-correlation between pairs of bipolar EHG signals (upper and lower, left and right), the conduction velocities and their directions were estimated using preterm and term EHG records of the publicly available Term–Preterm EHG DataSet with Tocogram (TPEHGT DS) and for different frequency bands below and above 1.0 Hz, where contractions and the influence of the maternal heart rate on the uterus, respectively, are expected. No significant or preferred continuous direction of propagation was found in any of the non-contraction (dummy) or contraction intervals; however, on average, a significantly lower percentage of velocity vectors was found in the vertical direction, and significantly higher in the horizontal direction, for preterm dummy intervals above 1.0 Hz. The newly defined features—the percentages of velocities in the vertical and horizontal directions, in combination with the sample entropy of the EHG signal recorded in the vertical direction, obtained from dummy intervals above 1.0 Hz—showed the highest classification accuracy of 86.8% () in distinguishing between preterm and term EHG records of the TPEHGT DS.