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Author Notes:

Gari D. Clifford, gari@gatech.edu

CV is funded by a Fulbright Scholarship. LS acknowledges the support of the RCUK Digital Economy Programme grant number EP/G036861/1 (Oxford Centre for Doctoral Training in Healthcare Innovation) and of the Oxford Centre for Affordable Healthcare Technology. GC acknowledges the support of the National Institutes of Health, the Fogarty International Center and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, grant number 1R21HD084114-01 (Mobile Health Intervention to Improve Perinatal Continuum of Care in Guatemala). The authors acknowledge the collaboration of the Institute of Biomedical Engineering, TU Dresden, and the Department of Obstetrics, University Hospital of Leipzig, for providing Doppler ultrasound and fetal electrocardiogram recordings.

Subject:

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Technology
  • Biophysics
  • Engineering, Biomedical
  • Physiology
  • Engineering
  • dimensional Doppler ultrasound
  • fetal heart rate
  • fetal monitoring
  • signal processing
  • autocorrelation function
  • RESEARCH GUIDELINES
  • NUMERICAL-ANALYSIS
  • ACCURACY
  • ELECTROCARDIOGRAM
  • CARDIOTOCOGRAPHY
  • SYSTEM

An open source autocorrelation-based method for fetal heart rate estimation from one-dimensional Doppler ultrasound

Tools:

Journal Title:

PHYSIOLOGICAL MEASUREMENT

Volume:

Volume 40, Number 2

Publisher:

, Pages 025005-025005

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Objective: Open research on fetal heart rate (FHR) estimation is relatively rare, and evidence for the utility of metrics derived from Doppler ultrasound devices has historically remained hidden in the proprietary documentation of commercial entities, thereby inhibiting its assessment and improvement. Nevertheless, recent studies have attempted to improve FHR estimation; however, these methods were developed and tested using datasets composed of few subjects and are therefore unlikely to be generalizable on a population level. The work presented here introduces a reproducible and generalizable autocorrelation (AC)-based method for FHR estimation from one-dimensional Doppler ultrasound (1D-DUS) signals. Approach: Simultaneous fetal electrocardiogram (fECG) and 1D-DUS signals generated by a hand-held Doppler transducer in a fixed position were captured by trained healthcare workers in a European hospital. The fECG QRS complexes were identified using a previously published fECG extraction algorithm and were then over-read to ensure accuracy. An AC-based method to estimate FHR was then developed on this data, using a total of 721 1D-DUS segments, each 3.75 s long, and parameters were tuned with Bayesian optimization. The trained FHR estimator was tested on two additional (independent) hand-annotated Doppler-only datasets recorded with the same device but on different populations: one composed of 3938 segments (from 99 fetuses) acquired in rural Guatemala, and another composed of 894 segments (from 17 fetuses) recorded in a hospital in the UK. Main results: The proposed AC-based method was able to estimate FHR within 10% of the reference FHR values 96% of the time, with an accuracy of 97% for manually identified good quality segments in both of the independent test sets. Significance: This is the first work to publish open source code for FHR estimation from 1D-DUS data. The method was shown to satisfy estimations within 10% of the reference FHR values and it therefore defines a minimum accuracy for the field to match or surpass. Our work establishes a basis from which future methods can be developed to more accurately estimate FHR variability for assessing fetal wellbeing from 1D-DUS signals.

Copyright information:

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (https://creativecommons.org/licenses/by-nc-nd/4.0/rdf).
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