This study investigates the efficacy of analyzing fetal heart rate (FHR) signals based on Artificial Intelligence to obtain a baseline calculation and identify accelerations/decelerations in the FHR through electronic fetal monitoring during labor.Methods: A total of 43,888 cardiotocograph(CTG) records of female patients in labor from January 2012 to December 2020 were collected from the NanFang Hospital of Southern Medical University. After filtering the data, 2341 FHR records were used for the study. The ObVue fetal monitoring system, manufactured by Lian-Med Technology Co. Ltd., was used to monitor the FHR signals for these pregnant women from the beginning of the first stage of labor to the end of delivery. Two obstetric experts together annotated the FHR signals in the system to determine the baseline as well as accelerations/ decelerations of the FHR. Our cardiotocograph network (CTGNet) as well as traditional methods were then used to automatically analyze the baseline and acceleration/deceleration of the FHR signals. The results of calculations were compared with the annotations provided by the obstetric experts, and ten-fold cross-validation was applied to evaluate them. The root-mean-square difference (RMSD) between the baselines, acceleration F-measure (Acc.F-measure), deceleration F-measure (Dec.F-measure), coefficient of synthetic inconsistency (SI) and the morphological analysis discordance index (MADI) were used as evaluation metrics. The data were analyzed by using a paired t-test.Results: The proposed CTGNet was superior to the best traditional method, proposed by Mantel, in terms of the RMSD.BL (1.7935 ± 0.8099 vs. 2.0293 ± 0.9267, t = À3.55 , P = 0.004),
CTG (cardiotocography) has consistently been used to diagnose fetal hypoxia. It is susceptible to identifying the average fetal acid-base balance but lacks specificity in recognizing prenatal acidosis and neurological impairment. CTG plays a vital role in intrapartum fetal state assessment, which can prevent severe organ damage if fetal hypoxia is detected earlier. In this paper, we propose a novel deep feature fusion network (DFFN) for fetal state assessment. First, we extract spatial and temporal information from the fetal heart rate (FHR) signal using a multiscale CNN-BiLSTM network, increasing the features’ diversity. Second, the multiscale CNN-BiLSM network and frequently used features are integrated into the deep learning model. The proposed DFFN model combines different features to improve classification accuracy. The multiscale convolutional kernels can identify specific essential information and consider signal’s temporal information. The proposed method achieves 61.97%, 73.82%, and 66.93% of sensitivity, specificity, and quality index, respectively, on the public CTU-UHB database. The proposed method achieves the highest QI on the private database, verifying the proposed method’s effectiveness and generalization. The proposed DFFN combines the advantages of feature engineering and deep learning models and achieves competitive accuracy in fetal state assessment compared with related works.
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