Recent Advances in Fetal Electrocardiography

Kimura, Yoshitaka; Sato, Nobuko; Sugawara, Junichi; Velayo, Clarissa; Hoshiai, Teturo; Nagase, Satoru; Ito, Takehiro; Onuma, Yukari; Katsumata, Asami; Okamura, Koji; Yaegashi, Nobuo

doi:10.2174/1875181401204010007

Cited by 22 publications

(18 citation statements)

References 10 publications

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“…However, study of HRA in prenatal development has never been reported before to our knowledge. Poincaré plot technique can be applied on shortterm data to explore the variability and dynamics in time domain as previously applied in other studies [4,14]. Fetal electrocardiography (ECG) that provides superior measurement of beat-to-beat intervals was used in this study.…”

Section: Discussionmentioning

confidence: 99%

“…Like fMCG, fetal electrocardiogram (fECG) is a non-invasive method for monitoring beat-beat fetal cardiac activity with sufficient precision. Although, extraction of fECG is difficult, we have reported blind source separation with reference signals (BSSR) technique for stable and reliable extraction of fECG [12][13][14][15]. Therefore, fECG is the simple and convenient method for non-invasive monitoring of fetal cardiac activity.…”

Section: Introductionmentioning

confidence: 99%

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Analysis of fetal heart rate asymmetry before and after 35 weeks of gestation

Karmakar

Kimura

Palaniswami

et al. 2015

Biomedical Signal Processing and Control

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a b s t r a c tIn this study, we have investigated the evidence of fetal heart rate asymmetry and how the fetal heart rate asymmetry changes before and after 35 weeks of gestation. Noninvasive fetal electrocardiogram (fECG) signals from 45 pregnant women at the gestational age from16 to 41 weeks with normal single pregnancies were analysed. A nonlinear parameter called heart rate asymmetry (HRA) index that measures time asymmetry of RR interval time-series signal was used to understand the changes of HRA in early and late fetus groups. Results indicate that fetal HRA measured by Porta's Index (PI) consistently increases after 35 weeks gestation compared to foetus before 32 weeks of gestation. It might be due to significant changes of sympatho-vagal balance towards delivery with more sympathetic surge. On the other hand, Guzik's Index (GI) showed a mixed effect i.e., increases at lower lags and decreases at higher lags. Finally, fHRA could potentially help identify normal and the pathological autonomic nervous system development.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Analysis of fetal heart rate asymmetry before and after 35 weeks of gestation

Karmakar

Kimura

Palaniswami

et al. 2015

Biomedical Signal Processing and Control

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“…However, taking into account the need to monitor a whole pregnancy period, only a noninvasive approach could be considered, which relies on indirect recording the FECG from electrodes located on maternal abdominal wall (Ungureanu et al, 2009; Vullings et al, 2010; Kimura et al, 2012; Khalaf et al, 2013; Behar et al, 2014; Agostinelli et al, 2015b). …”

Section: Introductionmentioning

confidence: 99%

Is Abdominal Fetal Electrocardiography an Alternative to Doppler Ultrasound for FHR Variability Evaluation?

et al. 2017

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Great expectations are connected with application of indirect fetal electrocardiography (FECG), especially for home telemonitoring of pregnancy. Evaluation of fetal heart rate (FHR) variability, when determined from FECG, uses the same criteria as for FHR signal acquired classically—through ultrasound Doppler method (US). Therefore, the equivalence of those two methods has to be confirmed, both in terms of recognizing classical FHR patterns: baseline, accelerations/decelerations (A/D), long-term variability (LTV), as well as evaluating the FHR variability with beat-to-beat accuracy—short-term variability (STV). The research material consisted of recordings collected from 60 patients in physiological and complicated pregnancy. The FHR signals of at least 30 min duration were acquired dually, using two systems for fetal and maternal monitoring, based on US and FECG methods. Recordings were retrospectively divided into normal (41) and abnormal (19) fetal outcome. The complex process of data synchronization and validation was performed. Obtained low level of the signal loss (4.5% for US and 1.8% for FECG method) enabled to perform both direct comparison of FHR signals, as well as indirect one—by using clinically relevant parameters. Direct comparison showed that there is no measurement bias between the acquisition methods, whereas the mean absolute difference, important for both visual and computer-aided signal analysis, was equal to 1.2 bpm. Such low differences do not affect the visual assessment of the FHR signal. However, in the indirect comparison the inconsistencies of several percent were noted. This mainly affects the acceleration (7.8%) and particularly deceleration (54%) patterns. In the signals acquired using the electrocardiography the obtained STV and LTV indices have shown significant overestimation by 10 and 50% respectively. It also turned out, that ability of clinical parameters to distinguish between normal and abnormal groups do not depend on the acquisition method. The obtained results prove that the abdominal FECG, considered as an alternative to the ultrasound approach, does not change the interpretation of the FHR signal, which was confirmed during both visual assessment and automated analysis.

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“…Despite this early documentation, the development of fetal ECG has lagged behind other techniques for fetal monitoring, partly because of technical challenges. The fetal signal has low amplitude (2–50 microvolts, 1/50th of the maternal ECG), and is masked by both the maternal electrocardiogram and background noises (maternal electromyogram), resulting in a low signal‐to‐noise ratio [25,26]. The fetus is surrounded by amniotic fluid and maternal tissues, which enlarge the distance to the electrodes and cause a non‐homogenous tissue conduction that interferes with signal quality.…”

Section: Introductionmentioning

confidence: 99%