A novel modular fetal ECG STAN and HRV analysis: Towards robust hypoxia detection

Martínek, Radek; Kahánková, Radana; Martin, Boris; Nedoma, Jan; Fajkus, Marcel

doi:10.3233/thc-181375

Cited by 7 publications

(9 citation statements)

References 35 publications

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“…However, in their study, the ECG was taken at 24–36 h of age. Our analysis approach and results are more in line with the fetal STAN-classification, where biphasic ST-segment changes signify more severe asphyxia [ 22 ]. Notably, STAN utilizes a 0.05 to 100 Hz bandwidth [ 14 ].…”

Section: Discussionsupporting

confidence: 69%

“…In contrast, biphasic ST-segment abnormalities are associated with bradycardia after birth and a need for prolonged BMV and might indicate significant asphyxia when this equipment is being used. Currently, automated systems for ECG classification are established for both adult [ 23 ] and fetal [ 22 ] ECG. Automated evaluation of the neonatal ECG, with appropriate bandwidth and automated analysis should be validated in future studies in order to evaluate whether this potentially can aid in the identification of severely asphyxiated infants.…”

Section: Discussionmentioning

confidence: 99%

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Delivery Room ST Segment Analysis to Predict Short Term Outcomes in Near-Term and Term Newborns

et al. 2022

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Background: ST-segment changes to the fetal electrocardiogram (ECG) may indicate fetal acidosis. No large-scale characterization of ECG morphology immediately after birth has been performed, but ECG is used for heart rate (HR) assessment. We aimed to investigate ECG morphology immediately after birth in asphyxiated infants, using one-lead dry-electrode ECG developed for HR measurement. Methods: Observational study in Tanzania, between 2013–2018. Near-term and term infants that received bag-mask ventilation (BMV), and healthy controls, were monitored with one-lead dry-electrode ECG with a non-diagnostic bandwidth. ECGs were classified as normal, with ST-elevations or other ST-segment abnormalities including a biphasic ST-segment. We analyzed ECG morphology in relation to perinatal variables or short-term outcomes. Results: A total of 494 resuscitated and 25 healthy infants were included. ST-elevations were commonly seen both in healthy infants (7/25; 28%) and resuscitated (320/494; 65%) infants. The apparent ST-elevations were not associated with perinatal variables or short-term outcomes. Among the 32 (6.4%) resuscitated infants with “other ST-segment abnormalities”, duration of BMV was longer, 1-min Apgar score lower and normal outcomes less frequent than in the resuscitated infants with normal ECG or ST-elevations. Conclusions: ST-segment elevation was commonly seen and not associated with negative outcomes when using one-lead dry-electrode ECG. Other ST-segment abnormalities were associated with prolonged BMV and worse outcome. ECG with appropriate bandwidth and automated analysis may potentially in the future aid in the identification of severely asphyxiated infants.

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Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Delivery Room ST Segment Analysis to Predict Short Term Outcomes in Near-Term and Term Newborns

et al. 2022

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“…A linear relationship exists between the increased amplitude of the T wave and the depletion of myocardial glycogen due to hypoxia. This relationship can be quantified by the ratio of T wave amplitude to QRS complex amplitude [84].…”

Section: Cardiac Responsementioning

confidence: 99%

Fetal monitoring technologies for the detection of intrapartum hypoxia - challenges and opportunities

Hussain,

O’Halloran,

McDermott

et al. 2024

Biomed. Phys. Eng. Express

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Intrapartum foetal hypoxia is related to long-term morbidity and mortality of the foetus and the mother. Foetal surveillance is extremely important to minimize the adverse outcomes arising from foetal hypoxia during labour. Several methods have been used in current clinical practice to monitor foetal well-being. For instance, biophysical technologies including cardiotocography, ST-analysis adjunct to cardiotocography, and Doppler ultrasound are used for intrapartum foetal monitoring. However, these technologies result in a high false-positive rate and increased obstetric interventions during labour. Alternatively, biochemical-based technologies including foetal scalp blood sampling and foetal pulse oximetry are used to identify metabolic acidosis and oxygen deprivation resulting from foetal hypoxia. These technologies neither improve clinical outcomes nor reduce unnecessary interventions during labour. Also, there is a need to link the physiological changes during foetal hypoxia to foetal monitoring technologies. The objective of this article is to assess the clinical background of foetal hypoxia and to review existing monitoring technologies for the detection and monitoring of foetal hypoxia. A comprehensive review has been made to predict foetal hypoxia using computational and machine-learning algorithms. The detection of more specific biomarkers or new sensing technologies is also reviewed which may help in the enhancement of the reliability of continuous foetal monitoring and may result in the accurate detection of intrapartum foetal hypoxia.

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“…9a, b. Once the ECG signals were filtered, R peaks were detected using a detector which applied a continuous wavelet transform (Gaussian mother wavelet with a width of one and five levels of decomposition) [109]. The distances between individual R peaks, i.e., RR intervals, were calculated and applied to ascertain the values of the current HR, the average HR, and the HRV parameters.…”

Section: Signal Processingmentioning

confidence: 99%

Alternative measurement systems for recording cardiac activity in animals: a pilot study

et al. 2022

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Monitoring and assessing cardiac activity in animals, especially heart rate variability, has been gaining importance in the last few years as an indicator of animal health, well-being and physical condition. This pilot study tested the sensors based on ballistocardiography sensing the mechanical vibrations caused by the animal’s cardiovascular system, which have proved useful in measuring cardiac activity in humans. To verify the accuracy of these measurement systems, the conventional measurements based on electrocardiography were carried out and the outcomes were compared. The main objectives were to verify the suitability of these sensors in measuring cardiac activity in animals, to determine the advantages and disadvantages of these sensors, and to identify future challenges. Measurements were performed on various animals, specifically a goat, a cow, a horse, and a sheep. Electrocardiographic measurement, which has demonstrated high accuracy in procedures for animals, was used as the study’s gold standard. A disadvantage of this method, however, is the long time required to prepare animals and shear spots to attach electrodes. The accuracy of a ballistocardiographic sensor was compared to reference electrocardiographic signals based on Bland–Altman plots which analysed the current heart rate values. Unfortunately, the ballistocardiographic sensor was highly prone to poor adhesion to the animal’s body, sensor movement when the animal was restless, and motion artefacts. Ballistocardiographic sensors were shown only to be effective with larger animals, i.e., the horse and the cow, the size of these animals allowing sufficient contact of the sensor with the animal’s body. However, this method’s most significant advantage over the conventional method based on electrocardiography is lower preparation time, since there is no need for precise and time-demanding fixation of the sensor itself and the necessity of shaving the animal’s body.

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A novel modular fetal ECG STAN and HRV analysis: Towards robust hypoxia detection

Cited by 7 publications

References 35 publications

Delivery Room ST Segment Analysis to Predict Short Term Outcomes in Near-Term and Term Newborns

Delivery Room ST Segment Analysis to Predict Short Term Outcomes in Near-Term and Term Newborns

Fetal monitoring technologies for the detection of intrapartum hypoxia - challenges and opportunities

Alternative measurement systems for recording cardiac activity in animals: a pilot study

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