Cardiotocography (CTG) is a non-invasive and important tool for diagnosing fetal distress during pregnancy. To meet the needs of intelligent fetal heart monitoring based on deep learning, this paper proposes a TWD-MOAL deep active learning algorithm based on the three-way decision (TWD) theory and multi-objective optimization Active Learning (MOAL). During the training process of a convolutional neural network (CNN) classification model, the algorithm incorporates the TWD theory to select high-confidence samples as pseudo-labeled samples in a fine-grained batch processing mode, meanwhile low-confidence samples annotated by obstetrics experts were also considered. The TWD-MOAL algorithm proposed in this paper was validated on a dataset of 16 355 prenatal CTG records collected by our group. Experimental results showed that the algorithm proposed in this paper achieved an accuracy of 80.63% using only 40% of the labeled samples, and in terms of various indicators, it performed better than the existing active learning algorithms under other frameworks. The study has shown that the intelligent fetal heart monitoring model based on TWD-MOAL proposed in this paper is reasonable and feasible. The algorithm significantly reduces the time and cost of labeling by obstetric experts and effectively solves the problem of data imbalance in CTG signal data in clinic, which is of great significance for assisting obstetrician in interpretations CTG signals and realizing intelligence fetal monitoring.
Humans ; Pregnancy ; Female ; Cardiotocography/methods* ; Deep Learning ; Neural Networks, Computer ; Algorithms ; Fetal Monitoring/methods* ; Heart Rate, Fetal ; Fetal Distress/diagnosis* ; Fetal Heart/physiology*

OBJECTIVE: To explore the feasibility of remote monitoring of neonatal jaundice in newborns with ABO hemolytic disease. METHODS: Forty six neonates of gestational age >35 weeks with ABO hemolytic disease admitted to Women's Hospital, Zhejiang University School of Medicine from January 20th, 2020 to February 29th, 2020 were enrolled in the study (study group). The newborns were followed up at home after discharge, the transcutaneous bilirubin (TCB) levels were measured by parents using the provided device and the results were sent to the doctor by smart phone using the installed APP. Fifty six newborns with ABO hemolytic disease admitted in 2018 who received conventional outpatient follow-up after discharge served as the control group. The demographic characteristics, total serum bilirubin (TSB) level during hospitalization, number of outpatient visit and rate of re-admission due to rebound hyperbilirubinemia were compared between the two groups. RESULTS: There were no significant differences between the two groups in gestational age, birth weight, delivery mode, gender, length of the first hospitalization, TSB level before phototherapy and before discharge, and the managements during the first hospitalization (all CONCLUSIONS The remote follow-up for neonatal jaundice at home can effectively reduce the number of outpatient visits without increasing the risk of readmission and severe neonatal hyperbilirubinemia for newborns with ABO hemolytic disease.
Bilirubin ; Erythroblastosis, Fetal/diagnosis* ; Female ; Humans ; Hyperbilirubinemia, Neonatal/diagnosis* ; Infant, Newborn ; Jaundice, Neonatal/diagnosis* ; Monitoring, Physiologic/methods* ; Phototherapy

INTRODUCTIONFetal distress is a result of acute or chronic disturbances in the system of "mother-placenta-fetus" in pre-eclampsia (PE). The aim of the investigation was to compare the accuracy of antenatal fetal distress diagnostics in cases of traditional cardiotocography (CTG) waveform evaluation and analysis of morphological non-invasive electrocardiogram (ECG) parameters in anterpartum patients with PE.

MATERIALS AND METHODSFetal non-invasive ECG antenatal recordings of 122 pregnant patients at 34 to 40 weeks of gestation were examined. In Group I, there were 32 women with physiological gestation and normal fetal condition according to haemodynamic Doppler values. Group II involved 48 patients with mild and moderate PE whom were performed Doppler investigation. In Group III, 42 patients with severe PE were monitored with haemodynamic Doppler.

RESULTSFetal autonomic tone was lower with the relative increase of low frequency (LF) branch in the patients of pre-eclamptic group. The increased value of the amplitude of mode (AMo) and stress index (SI) was associated with adrenergic overactivity. It has induced pQ and QT shortening, increased T/QRS ratio and decelerations appearance. The rate of antenatal fetal distress retrospectively was 31.1 % in PE. The traditional analysis of CTG parameters has showed sensitivity (72.7%) and specificity (87.1%). In addition to the conventional CTG analysis, evaluation of ECG parameters has contributed to better diagnostics of fetal distress. Sensitivity and specificity of non-invasive fetal ECG were absolutely equal in this study (100%).

CONCLUSIONThe results suggest that fetal non-invasive ECG monitoring is more objective than conventional CTG.

Cardiotocography ; methods ; Cross-Sectional Studies ; Electrocardiography ; methods ; Female ; Fetal Distress ; diagnosis ; physiopathology ; Fetal Monitoring ; Heart Rate, Fetal ; Humans ; Pre-Eclampsia ; Pregnancy ; Pregnancy Trimester, Third ; Retrospective Studies ; Sensitivity and Specificity ; Severity of Illness Index ; Ultrasonography, Doppler ; Ultrasonography, Prenatal

The electrocardiograph signal presents the sparseness. In this paper, a new method of extracting the Fetal Electrocardiograph (FECG) is proposed, which uses the Blind Source Separation(BSS) of Sparse Signal. Both the Wavelet Analysis method and a new scheme named Vanish Circle are also involved in order to avoid the influence on the signal separation, because the ECG signals are not completed sparse signals. Some experiments show that the new method is effective.
Adult ; Algorithms ; Electrocardiography ; methods ; Female ; Fetal Heart ; physiology ; Fetal Monitoring ; methods ; Humans ; Pattern Recognition, Automated ; methods ; Pregnancy ; Signal Processing, Computer-Assisted

INTRODUCTIONIntrapartum fetal monitoring is essential for the identification of fetal hypoxia to reduce perinatal morbidity and mortality. Cardiotocography is associated with low specificity for fetal acidosis and poor perinatal outcome leading to unnecessary operative deliveries. ST waveform analysis of the fetal electrocardiogram has been shown to be a promising adjunctive intrapartum assessment tool. We aim to present the pathophysiology, the role of intrapartum monitoring and the practical usage of this relatively new technology in our review.

METHODSAn electronic search of Medline and OVID was carried out, followed by a manual search of the references identified by the electronic search.

RESULTSThe incorporation of ST waveform analysis to cardiotocography has been shown to reduce the rates of neonatal metabolic acidosis, moderate and severe neonatal encephalopathy, thus improving perinatal outcome. The reduction in operative delivery rates due to fetal distress is also significant. The pathophysiology and practical usage of this technology were discussed.

CONCLUSIONSWith more accurate identification of fetal hypoxia and reduction of unnecessary intervention rates, incorporation of ST waveform analysis of fetal electrocardiography into cardiotocography can improve the standard of intrapartum fetal monitoring.

Electrocardiography ; utilization ; Female ; Fetal Hypoxia ; diagnosis ; Fetal Monitoring ; instrumentation ; methods ; Humans ; Pregnancy ; Singapore

The paper presents the development and design of an ultrasonic Doppler fetal heart rate monitoring system based on DSP, and explains the realization of a algorithm for detecting fetal heart rate. Clinical practice has proved that this system is able to pick up the real-time fetal heart rate correctly and rapidly.
Algorithms ; Fetal Monitoring ; instrumentation ; methods ; Heart Rate, Fetal ; physiology ; Humans ; Sensitivity and Specificity ; Signal Processing, Computer-Assisted ; Ultrasonography, Doppler ; instrumentation ; methods ; Ultrasonography, Prenatal ; instrumentation ; methods

Various interference and noises should be eliminated while picking up the signal of fetal heart rate from the Doppler fetal signal in order to obtain smooth curve of the fetal heart Doppler signal and so to figure out the fetal heart rate. In this study, the mean frequency shift curve estimated from the Doppler fetal signals was smoothed using wavelet transform. The results showed that the fetal-heart rate obtained by computing from the autocorrelation waveform based on the smoothed mean frequency shift curve was more accurate than that based on unsmoothed curve.
Female ; Fetal Monitoring ; Heart Rate, Fetal ; physiology ; Humans ; Pregnancy ; Signal Processing, Computer-Assisted ; Ultrasonography, Doppler ; methods ; Ultrasonography, Prenatal

OBJECTIVETo study the accuracy of the application of the intrapartum fetal oxygen saturation (FSO2) monitoring in predicting fetal acidosis and diagnosing intrauterine fetal distress.

METHODSContinuous FSO2 monitoring as well as internal and external fetal heart rate monitoring were applied respectively in 60 women in labor during active phase of the first stage and the second stage. All the monitoring methods were validated with standard sensitivity, specificity, positive predictive value, negative predictive value, and accuracy on the bases of Apgar score and cord artery blood analysis.

RESULTSThe mean FSO2 in the active phase of the first stage were significantly higher than in the second stage of labor. FSO2 correlated with pH, PO2, PCO2, and base excess (BE) of cord blood to a significant degree. There was linear correlation between FSO2 and cord artery blood pH. Using 30% cutoff diagnosing intrauterine fetal distress, the sensitivity, specificity, and accuracy were 80%, 100% and 98.3%, respectively.

CONCLUSIONFSO2 monitoring is an effective method diagnosing intrauterine fetal distress.

Acidosis ; diagnosis ; Apgar Score ; Female ; Fetal Blood ; chemistry ; Fetal Distress ; blood ; diagnosis ; Fetal Monitoring ; methods ; Heart Rate, Fetal ; Humans ; Monitoring, Physiologic ; Oximetry ; methods ; Oxygen ; blood ; Partial Pressure ; Pregnancy ; Prenatal Diagnosis