Abstract
AIM: The aim of this project is to develop an algorithm to monitor online the fetal heart rate (fHR) and fetal electrocardiogram (fECG) from maternal abdominal recordings.
METHODS: Measurements have been performed using 12 electrodes on the abdomen of the mother. In an initialization phase, the algorithm calculates the fetal signal for each electrode after effectively removing the maternal ECG and suppressing the electromyogram (EMG). Next, the algorithm selects the 4 signals in which the fetal component is most present and uses these signals for further calculations. The reduction of the number of electrodes used in the calculation decreases computation times significantly and enables the algorithm to monitor the fHR online. To increase the signal-to-noise ratio of the calculated fECG complex, 10 consecutive PQRS complexes are averaged. By means of cross correlating the PQRS complexes, PQRS complexes containing artifacts are excluded from the averaging process. The algorithm is validated by comparing the calculated fHR from abdominal recordings to the fHR determined from direct ECG signals measured with a scalp electrode.
RESULTS: A total of 530 paired fECG complexes are analyzed. The fHR obtained from both methods correlates very well (correlation coefficient 0.99, p<0.001). The resulting fECG complex clearly shows the fetal P-wave, QRS-complex and T-wave.
CONCLUSIONS: The proposed algorithm provides a valuable tool for obtaining noninvasively and online information of the fHR and fECG in stages of pregnancy earlier than labor. Future research is aimed at the uterine EMG, morphology of the fetal PQRS complexes and fHR variability analysis in order to obtain more detailed information of the fetal condition.
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Vullings, R., Peters, C., Andriessen, P. et al. 408 Monitoring the Fetal Heart Rate and Fetal Electrocardiogram: Abdominal Recordings are as Good as Direct ECG Measurements. Pediatr Res 58, 424 (2005). https://doi.org/10.1203/00006450-200508000-00437
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DOI: https://doi.org/10.1203/00006450-200508000-00437