A low-cost perinatal monitoring system for use in rural Guatemala

Stroux, Lisa; King, Natasha; Fathima, Sana; Hall-Clifford, Rachel; Rohloff, Peter; Clifford, Gari D.

doi:10.1049/cp.2014.0777

Cited by 11 publications

(41 citation statements)

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“…It is also possible to use only 1-D DUS to obtain ICT, VET, IRT and VFT as described in our previous paper [18]. Since 1-D DUS device can cost as little as $17 and can be performed by nonexperts with limited training, it can be used to estimate the GA in resource limited settings [6].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore alternative techniques are needed as an adjunct or substitute where ultrasound methods are unavailable or inadequate due to pathologies, unsuitable positioning or technical issues. one promising alternative GA estimator is Fetal Heart Rate (FHR), which is affordable and applicable without special skills, hence feasible for low income countries [4][5][6]. Various FHR variability (FHRV) parameters were found closely related to the fetal maturation [5,7].…”

Section: Introductionmentioning

confidence: 99%

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Estimating Fetal Gestational Age Using Cardiac Valve Intervals

Marzbanrad

Khandoker

Kimura

et al. 2016

2016 Computing in Cardiology Conference (CinC)

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A new automated method for estimation of the gestational age is presented in this paper based on the intervals between fetal cardiac valve timings and the Q-wave of fetal electrocardiogram (fECG). The intervals were estimated automatically from one-dimensional Doppler Ultrasound and noninvasive fECG. Among the intervals, Isovolumic Contraction Time, Electromechanical Delay Time, Ventricular Filling Time and their interactions were selected in a stepwise regression process. Compared with Crown-Rump Length as gold standard, a mean absolute error of 3.8 weeks was obtained using leave-one-out cross validation. This method also outperformed a fetal heart rate based approach. Since valve intervals reflect the autonomic function, this method provides a novel measure of the development of fetal autonomic nervous system that may be growth curve independent.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Estimating Fetal Gestational Age Using Cardiac Valve Intervals

Marzbanrad

Khandoker

Kimura

et al. 2016

2016 Computing in Cardiology Conference (CinC)

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“…The percentages of signal quality are comparable to those of data collected by healthcare professionals in the UK using the same prototype (N patients = 17) [21], [22]. Applying the SQI algorithm, 55% of the total dataset was classified as poor, 45% as of good quality.…”

Section: Feasibility Testingmentioning

confidence: 52%

An mHealth monitoring system for traditional birth attendant-led antenatal risk assessment in rural Guatemala

Stroux

Martinez

Ixen

et al. 2016

Journal of Medical Engineering & Technology

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Limited funding for medical technology, low levels of education and poor infrastructure for delivering and maintaining technology severely limit medical decision support in low- and middle-income countries. Perinatal and maternal mortality is of particular concern with millions dying every year from potentially treatable conditions. Guatemala has one of the worst maternal mortality ratios, the highest incidence of intrauterine growth restriction (IUGR), and one of the lowest gross national incomes per capita within Latin America. To address the lack of decision support in rural Guatemala, a smartphone-based system is proposed including peripheral sensors, such as a handheld Doppler for the identification of fetal compromise. Designed for use by illiterate birth attendants, the system uses pictograms, audio guidance, local and cloud processing, SMS alerts and voice calling. The initial prototype was evaluated on 22 women in highland Guatemala. Results were fed back into the refinement of the system, currently undergoing RCT evaluation.

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“…pregnant women (Martinez et al , 2018; Stroux et al , 2017; Valderrama et al , 2018). These low-cost devices can be easily adapted to connect to mobile devices such as smart phones, for recording and processing, motivating their use in mobile-health (mhealth) systems for risk screening in low-resource environments (Stroux et al , 2016; Stroux & Clifford, 2016). Table 1 summarizes available methods for non-invasive fetal monitoring, their affordability, training burden and availability in LMICs.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore an averaging process is performed, often resulting in a less useful FHRV signal (Jezewski et al , 2017; Lee et al , 2009b). Technical improvements of the hardware apparatus, the introduction of new cost-effective techniques, and the development of clinical support systems have been recently investigated to address the issues of prevention of unnecessary interventions and perinatal morbidity and mortality (Marzbanrad et al , 2014a; Stroux & Clifford, 2016). A new application of 1D-DUS has been also introduced for assessment of fetal heart function beyond the FHR, through identification of fetal heart valve movements, further facilitating monitoring of fetal well-being and development (Marzbanrad, 2015; Marzbanrad et al , 2017, 2014d).…”

Section: Introductionmentioning

confidence: 99%

Cardiotocography and beyond: a review of one-dimensional Doppler ultrasound application in fetal monitoring

2018

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One-dimensional Doppler ultrasound (1D-DUS) provides a low-cost and simple method for acquiring a rich signal for use in cardiovascular screening. However, despite the use of 1D-DUS in cardiotocography (CTG) for decades, there are still challenges that limit the effectiveness of its users in reducing fetal and neonatal morbidities and mortalities. This is partly due to the noisy, transient, complex and nonstationary nature of the 1D-DUS signals. Current challenges also include lack of efficient signal quality metrics, insufficient signal processing techniques for extraction of fetal heart rate and other vital parameters with adequate temporal resolution, and lack of appropriate clinical decision support for CTG and Doppler interpretation. Moreover, the almost complete lack of open research in both hardware and software in this field, as well as commercial pressures to market the much more expensive and difficult to use Doppler imaging devices, has hampered innovation. This paper reviews the basics of fetal cardiac function, 1D-DUS signal generation and processing, its application in fetal monitoring and assessment of fetal development and wellbeing. It also provides recommendations for future development of signal processing and modeling approaches, to improve the application of 1D-DUS in fetal monitoring, as well as the need for annotated open databases.

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A low-cost perinatal monitoring system for use in rural Guatemala

Cited by 11 publications

References 0 publications

Estimating Fetal Gestational Age Using Cardiac Valve Intervals

Estimating Fetal Gestational Age Using Cardiac Valve Intervals

An mHealth monitoring system for traditional birth attendant-led antenatal risk assessment in rural Guatemala

Cardiotocography and beyond: a review of one-dimensional Doppler ultrasound application in fetal monitoring

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