APPARATUS, COMPUTER-ACCESSIBLE MEDIUM, SYSTEM AND METHOD FOR DETECTION, ANALYSIS AND USE OF FETAL HEART RATE AND MOVEMENT
20210330205 · 2021-10-28
Assignee
Inventors
Cpc classification
A61B5/11
HUMAN NECESSITIES
A61B2562/0219
HUMAN NECESSITIES
International classification
A61B5/11
HUMAN NECESSITIES
Abstract
Exemplary embodiments of the present invention provide for an apparatus, computer-accessible medium, system and method for detection, analysis and use of fetal heart rate and movement. In accordance with certain exemplary embodiments of the present disclosure, an exemplary system can include: at least one electrocardiogram sensor providing first signals or information regarding the at least one subject; a plurality of inertial measurement units providing second signals or information regarding the at least one subject; a plurality of acoustic sensors providing third signals or information regarding the at least one subject; and a processor, wherein the processor is configured to determine data regarding the fetal heart rate based on the first, second and third signals or information.
Claims
1. A system for detecting fetal heart rate (FHR) of a subject, comprising: a plurality of inertial measurement units (IMUs) configured to detect the FHR based on at least one of (i) a seismo-cardiogram (SCG) signal, or (ii) a gyro-cardiogram (GCG) signal received from at least one portion the subject.
2. The system of claim 1, further comprising: a plurality of acoustic sensors configured to detect the FHR.
3. The system of claim 2, wherein the plurality of acoustic sensors are configured to forward beam-formed signals provided thereby.
4. The system of claim 1, further comprising: at least one electrocardiogram (ECG) sensor is configured to detect the FHR.
5. The system of claim 4, wherein the at least one ECG sensor is a single-lead ECG sensor.
6. The system of claim 1, wherein each of the plurality of IMUs includes an accelerometer and a gyroscope.
7. The system of claim 1, wherein the plurality of IMUs are configured to detect a movement of the subject.
8. A system for detecting fetal heart rate (FHR) of at least one subject, comprising: at least one sensor configured to detect the FHR, wherein the at least one sensor comprises at least one of: a plurality of acoustic sensors which are configured to forward beam-formed signals provided thereby, or at least one single-lead electrocardiogram (ECG) sensor.
9. The system of claim 8, further comprising: a plurality of inertial measurement units (IMUS) which are configured to detect at least one of (i) the FHR or (ii) a fetal movement of the at least one subject.
10. The system of claim 8, further comprising: at least one electrocardiogram (ECG) sensor configured to detect the FHR.
11. The system of claim 10, wherein the at least one ECG sensor is a single-lead ECG sensor.
12. The system of claim 8, wherein the at least one sensor comprises the plurality of acoustic sensors which are configured to forward the beam-formed signals provided thereby
13. A system for determining fetal heart rate (FHR) of at least one subject, comprising: at least one electrocardiogram (ECG) sensor providing first signals or information regarding the at least one subject; a plurality of inertial measurement units (IMUs) providing second signals or information regarding the at least one subject; a plurality of acoustic sensors providing third signals or information regarding the at least one subject; and at least one computer processor which is configured to determine data regarding the FHR based on the first, second and third signals or information.
14. The system of claim 13, wherein the at least one ECG sensor is a single-lead ECG sensor.
15. The system of claim 13, wherein the plurality of acoustic sensors are configured to provide beam-formed signals to the at least one subject.
16. The system of claim 13, wherein the IMUs which are configured to detect at least one of (i) the FHR or (ii) a fetal movement of the at least one subject.
17. A method for determining fetal heart rate (FHR) of at least one subject, comprising: with at least one electrocardiogram (ECG) sensor, obtaining first signals or information regarding the at least one subject; with a plurality of inertial measurement units (IMUs), obtaining second signals or information regarding the at least one subject; with a plurality of acoustic sensors, obtaining third signals or information regarding the at least one subject; and with a processor, determining data regarding the FHR based on the first, second and third signals or information.
18. The method of claim 17, wherein the at least one ECG sensor is a single-lead ECG sensor.
19. The method of claim 17, wherein the plurality of acoustic sensors are configured to provide beam-formed signals to the at least one subject.
20. The method of claim 17, wherein the IMUs which are configured to detect at least one of (i) the FHR or (ii) a fetal movement of the at least one subject.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0015] Further objects, features and advantages of the present disclosure will become apparent from the following detailed description taken in conjunction with the accompanying
[0016] Figures showing illustrative embodiments of the present disclosure, in which:
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[0028] Throughout the drawings, the same reference numerals and characters, unless otherwise stated, are used to denote like features, elements, components or portions of the illustrated embodiments. Moreover, while the present disclosure will now be described in detail with reference to the figures, it is done so in connection with the illustrative embodiments and is not limited by the particular embodiments illustrated in the figures and the appended claims.
DETAILED DESCRIPTION OF EXEMPLARY EMBODIMENTS
[0029] According to an exemplary embodiment of the present disclosure, an exemplary system can be provided which can have a few parts/portions thereof. The first part of the exemplary system can be or include a wearable wireless hardware platform consisting of sensor arrays that collect recordings with precise timing for synchronization. The wearable device can be placed on the surface of a subject's abdomen. An illustration of an exemplary system which shows an exemplary layout of the sensors is provided in
[0030] The exemplary system 105 can also contain integrated circuit chips (ICs), such as, e.g., a microcontroller unit (MCU) and/or low-power field programmable gate arrays (FPGA), wireless communication chips, as well as other active and passive peripheral components such as resistors, connectors, capacitors, power ICs and printed circuit boards (PCB), represented by the black and the light-color squares in
[0031] According to an exemplary embodiment of the present disclosure, the IMUs can pick up/detect vibrations that are induced by fetal heartbeat and movements from the abdominal wall. In particular, the accelerometers can measure a seismo-cardiogram (SCG) signal, while the gyroscopes can measure the gyro-cardiogram (GCG) signal. The SCG signal can be defined as the heartbeat-induced micro-vibrations of the chest wall. The GCG signal corresponds to the rotational components of heart-induced chest vibrations. The acoustic sensors can collect the acoustic information caused by fetal heartbeat, which is also known as fetal phonocardiogram. The electrodes 130 can record the abdominal electrocardiogram (aECG) signal, which can be the electric potential generated by maternal and fetal cardiac activities on the abdominal wall. Based on this gathered data, the FHR and FMV can be derived. According to an exemplary embodiment, the FHR can be presented in the unit of beats per minute (BPM). Further, the FHR can be derived continuously by fusing the raw signals from the IMU sensors, acoustic sensors, and aECG electrodes. Further, the maternal ECG components of the aECG can be removed during the fusion so that the fetal ECG can be extracted. Additional information can be inferred from FHR such as baseline FHR, FHR variability, FHR acceleration, and FHR deceleration. These exemplary parameters can used to determine the cardiac wellness of the fetus. Further, the
[0032] FMV can be detected via the IMUs. The strength, duration, and repetition frequency of the movements can be recorded by the system and analyzed to determine the activity level of the fetus. The data can then be transmitted wirelessly to a personal computer or smartphone application, which can then evaluate the wellbeing of the fetus and detect potential fetal abnormalities.
[0033] According to an exemplary embodiment of the present disclosure, another part/portion of the exemplary system can be a signal processing software which can include the embedded firmware in the wearable device as well as the software on the smartphone or personal computer (PC) application. The embedded software can manage the sensors and conducts signal processing and noise reduction. Useful pieces of data (for example, peak timing and amplitude information) can then be compressed and wirelessly transferred to the smartphone or PC application in real time. In an exemplary embodiment of the present disclosure, the application can store, log, store and analyze the data and provide feedback to the user and/or proper notice to the physician via internet connections.
[0034]
[0035] The FHR components from the IMU sensors can be fed into an exemplary sensor fusion procedure in 235, together with the FHR components from the acoustic beamforming output in 225, which are provided from acoustic sensor array(s) provided in 220. The exemplary sensor fusion procedure can clean the noisy single-lead fECG using these FHR components, which can generates clean fECG recordings. The FHR metrics can then be calculated or otherwise determined from the fECG recordings in 240.
[0036] Exemplary Procedure for Extracting FHR Components from the IMUs
[0037] Exemplary Experimental Setup—
[0038] Experimental Protocol—The experiment can be conducted in an fCTG examination room with an adjustable bed as shown in
[0039] Exemplary Signal Processing Method—Pre-Filtering—In the exemplary axis system of the IMU sensors, the z-axis refers to the dorso-ventral direction of the body. The z-axis of the SCG signal can be evaluated first before fusing the information from multiple axes. For the GCG modality, the y-axis rotation signal can be selected due to the higher quality for this axis.
[0040] Exemplary SCG and GCG recordings from the corresponding axes can be band-pass filtered to focus on the desired frequency components. A zero-phase infinite impulse response (IIR) filter that passes from 0.8 Hz to 50 Hz can be used to pre-filter the SCG waveforms.
[0041] Exemplary Signal Processing Method—Signal Fusion of Multiple Sensors—The ensemble of the recordings in time domain is not suitable for analysis since the axes of the signals from different sensors are misaligned due to the abdominal wall being a curved surface.
[0042] Therefore, the vibration components from different sensors do not align in the same direction and hence the direct summation of the amplitudes would be misleading. In this regard, the signals can be processed using time-frequency analysis based on continuous wavelet transform (CWT). CWT converts the signal into the time-frequency domain, so that the desired frequency components can be fused without losing the time-domain variations. The pre-processed SCG and GCG signals can be converted by CWT with a Morse wavelet, as provided below:
Ψ.sub.P,γ(ω)=U (ω) α.sub.p,65 ω.sup.(P.sup.
where P is the time-bandwidth product and γ is the symmetry parameter. In this regard, γ can be set to 3 and P can be set 120. The dominant frequency band of the FHR signals is located based on the power distribution of the CWT coefficients. An averaging function can then fuse the CWT coefficients from the corresponding frequency band of the three sensors. Then, a frequency-selective inverse CWT can be conducted to reconstruct a signal that represents FHR. The exemplary results from a representative SCG segment are shown in
[0043] Signal Processing Method—FHR Extraction—The spectrums of the fused waveforms can be analyzed by the cepstrum method. The cepstrum is defined as the inverse Fourier transform of the real logarithm of the magnitude of the Fourier transform of a time-domain sequence. The exemplary method can be presented in the equation below:
Csig=real(F.sup.−1 {log(F|(x)|)}.
[0044] In the above equation, x represents the fused waveform from CWT shown in the exemplary plots of
[0045] Based on the sensor fusion framework described above, the FHR can then be extracted from the recordings. The sliding window for CWT can be set to 5 seconds to approximate the averaging process. The FHR recordings from the reference fCTG can range between 120 and 180 BPM. Therefore, the FHR can be targeted within this range. The highest peak that locates in the range from 0.33 to 0.5 seconds (2 Hz to 3 Hz in repeating frequency) can be identified as the FHR period.
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[0048] As shown in
[0049] Further, the exemplary processing arrangement 705 can be provided with or include an input/output ports 735, which can include, for example a wired network, a wireless network, the internet, an intranet, a data collection probe, a sensor, etc. As shown in
[0050] According to an exemplary embodiment of the present disclosure, the exemplary system can be used to detect FHR and/or FMV at 28 weeks of the gestational life of a fetus.
[0051] The foregoing merely illustrates the principles of the disclosure. Various modifications and alterations to the described embodiments will be apparent to those skilled in the art in view of the teachings herein. It will thus be appreciated that those skilled in the art will be able to devise numerous systems, arrangements, and procedures which, although not explicitly shown or described herein, embody the principles of the disclosure and can be thus within the spirit and scope of the disclosure. Various different exemplary embodiments can be used together with one another, as well as interchangeably therewith, as should be understood by those having ordinary skill in the art. In addition, certain terms used in the present disclosure, including the specification, drawings and claims thereof, can be used synonymously in certain instances, including, but not limited to, for example, data and information. It should be understood that, while these words, and/or other words that can be synonymous to one another, can be used synonymously herein, that there can be instances when such words can be intended to not be used synonymously. Further, to the extent that the prior art knowledge has not been explicitly incorporated by reference herein above, it is explicitly incorporated herein in its entirety. All publications referenced are incorporated herein by reference in their entireties.
EXEMPLARY REFERENCES
[0052] The following references are hereby incorporated by reference, in their entireties:
[0053] 1. M. F. MacDorman, S. E. Kirmeyer, and E. C. Wilson, “Fetal and perinatal mortality, United States, 2006,” Nat. Vital Statist. Rep., vol. 60, no. 8, pp. 1-22, 2012.
[0054] 2. F. J. Korteweg et al., “A placental cause of intra-uterine fetal death depends on the perinatal mortality classification system used,” Placenta, vol. 29, no. 1, pp. 71-80, 2008.
[0055] 3. V. Flenady et al., “An evaluation of classification systems for stillbirth,” BMC Pregnancy Childbirth, vol. 9, p. 24, Jun. 2009.
[0056] 4. Perinatal Mortality 2009, CMACE, London, U.K., 2011.
[0057] 5. R. L. Goldenberg et al., “Stillbirths: The vision for 2020,” Lancet, vol. 377, pp. 1798-1805, May 2011.
[0058] 6. R. Brown, J. H. B. Wijekoon, A. Fernando, E. D. Johnstone, and A. E. P. Heazell, “Continuous objective recording of fetal heart rate and fetal movements could reliably identify fetal compromise, which could reduce stillbirth rates by facilitating timely management,” Med. Hypotheses, vol. 83, no. 3, pp. 410-417, 2014.
[0059] 7. R. Sameni and G. D. Clifford, “A review of fetal ECG signal processing; Issues and promising directions,” Open Pacing, Electrophysiol. Therapy vol. 3, p. 4, Jan. 2010.
[0060] 8. S. P. von Steinburg et al., “What is the ‘normal’ fetal heart rate?” Pier J., vol. 1, Jun. 2013. [Online]. Available: https://peerj.com/articles/82/.
[0061] 9. J. F. Frøen et al., “Restricted fetal growth in sudden intrauterine unexplained death,” Acta Obstetricia Gynecologica Scandinavica, vol. 83, no. 9, pp. 801-807, 2004.
[0062] 10. R. K. Freeman, Fetal Heart Rate Monitoring. Philadelphia, Pa., USA: Lippincott Williams & Wilkins, 2012.
[0063] 11. E. W. Abdulhay, R. J. Oweis, A. M. Alhaddad, F. N. Sublaban, M. A. Radwan, and H. M. Almasaeed, “Review article: Non-invasive fetal heart rate monitoring techniques,” Biomed. Sci. Eng., vol. 2, no. 3, pp. 53-67, 2014.
[0064] 12. B. K. Young, H. N. Weinstein, H. M. Hochberg, and M. E. George, “Observations in perinatal heart rate monitoring. I. A quantitative method of describing baseline variability of the fetal heart rate,” J Reproductive Med., vol. 20, no. 4, pp. 205-212, 1978.
[0065] 13. K. Nicolaides et al. (2002). Doppler in Obstetrics. [Online]. Available: http://www/fetalmedicine/com/fmf/Doppler%20in%20Obstetrics.pdf
[0066] 14. Avoid Fetal ‘Keepsake ’ Images, Heartbeat Monitors. Accessed: Jul. 30, 2019. [Online]. Available: https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm095508.htm
[0067] 15. R. Vullings, C. H. L. Peters, M. Mischi, S. G. Oei, and J. W. M. Bergmans, “Fetal movement quantification by fetal vectorcardiography: A preliminary study,” in Proc. 30th Annu. Int. Conf. IEEE Eng. Med. Biol. Soc., Aug. 2008, pp. 1056-1059.
[0068] 16. E. M. Graatsma, “Monitoring of fetal heart rate and uterine activity,” Ph.D. dissertation, Utrecht Univ., Utrecht, The Netherlands, 2010.
[0069] 17. E. M. Graatsma, B. C. Jacod, L. A. J. van Egmond, E. J. H. Mulder, and G. H. A. Visser, “Fetal electrocardiography: Feasibility of long-term fetal heart rate recordings,” BJOG, Int. J. Obstetrics Gynaecol., vol. 116, no. 2, pp. 334-338, 2009.
[0070] 18. Monica. Introducing the Monica AN24. Accessed: Jul. 30, 2019. [Online]. Available: http://www.monicahealthcare.com/products/
[0071] 19. Avalon Fetal Monitor. [Online]. Accessed: Jul. 30, 2019. Available: https://www.usa.philips.com/healthcare/resources/landing/avalon
[0072] 20. A. Fanelli et al., “Prototype of a wearable system for remote fetal monitoring during pregnancy,” in Proc. Annu. Int. Conf. IEEE Eng. Med. Biol., Sep. 2010, pp. 5815-5818.
[0073] 21. T. H. Sree, M. Garimella, A. Bandari, and I. Patel, “Microcontroller based fetal heart rate monitoring using intelligent biosystem,” in Proc. 3rd Int. Conf. Electron., Biomed. Eng. Appl. (ICEBEA), Singapore, Apr. 2013, pp. 152-156.
[0074] 22. K. B. Gan, E. Zahedi, and M. A. M. Ali, “Investigation of optical detection strategies for transabdominal fetal heart rate detection using three-layered tissue model and Monte Carlo simulation,” Optica Appl., vol. 41, no. 4, pp. 885-896, 2011.
[0075] 23. R. Martinek, “A phonocardiographic-based fiber-optic sensor and adaptive filtering system for noninvasive continuous fetal heart rate monitoring,” Sensors, vol. 17, no. 4, p. 890, 2017.
[0076] 24. F. Kovacs, M. Torok, and I. Habermajer, “A rule-based phonocardiographic method for long-term fetal heart rate monitoring,” IEEE Trans. Biomed. Eng., vol. 47, no. 1, pp. 124-130, Jan. 2000.
[0077] 25. D. G. Talbert, W. L. Davies, F. Johnson, N. Abraham, N. Colley, and D. P. Southall, “Wide bandwidlt fetal phonography using a sensor matched to the compliance of the mother's abdominal wall,” IEEE Trans. Biomed. Eng., vol. BME-33, no. 2, pp. 175-181, Feb. 1986.
[0078] 26. V. Padmanabhan, J. L. Semmlow, and W. Welkowitz, “Accelerometer type cardiac transducer for detection of low-level heart sounds,” IEEE Trans. Biomed. Eng., vol. 40, no. 1, pp. 21-28, Jan. 1993.
[0079] 27. K. Nishihara, S. Horiuchi, H. Eto, and M. Honda, “A long-term monitoring of fetal movement at home using a newly developed sensor: An introduction of maternal micro-arousals evoked by fetal movement during maternal sleep,” Early Hum. Develop., vol. 84, no. 9, pp. 595-603, 2008.
[0080] 28. B. Boashash, M. S. Khlif, T. Ben-Jabeur, C. E. East, and P. B. Colditz, “Passive detection of accelerometer-recorded fetal movements using a time-frequency signal processing approach,” Digit. Signal Process., vol. 25, pp. 134-155, Feb. 2014.
[0081] 29. M. Altini, “Detection of fetal kicks using body-worn accelerometers during pregnancy: Trade-offs between sensors number and positioning,” in Proc. 38th Annu. Int. Conf. IEEE Eng. Med. Biol. Soc. (EMBC), Aug. 2016, pp. 5319-5322.
[0082] 30. M. Mesbah, M. S. Khlif, C. East, J. Smeathers, P. Colditz, and B. Boashash, “Accelerometer-based fetal movement detection,” in Proc. Annu. Int. Conf. IEEE Eng. Med. Biol. Soc., Aug./Sep. 2011, pp. 7877-7880.
[0083] 31. M. Etemadi and O. T. Inan, “Wearable ballistocardiogram and seismocardiogram systems for health and performance,” J. Appl. Physiol., vol. 124, no. 2, pp. 452-461, 2018.
[0084] 32. C. Yang and N. Tavassolian, “Combined seismo- and gyro-cardiography: A more comprehensive evaluation of heart-induced chest vibrations,” IEEE J. Biomed. Health Inform., vol. 22, no. 5, pp. 1466-1475, Sep. 2018.
[0085] 33. M. J. Tadi et al., “Gyrocardiography: A new non-invasive monitoring method for the assessment of cardiac mechanics and the estimation of hemodynamic variables,” Sci. Rep., vol. 7, Jul. 2017, Art. no. 6823.
[0086] 34. (2019). Shimmer Sensing. Accessed: Jul. 30, 2019. [Online]. Available: https://www.shimmersensing.com
[0087] 35. F. Bousefsaf, C. Maaoui, and A. Pruski, “Continuous wavelet filtering on webcam photoplethysmographic signals to remotely assess the instantaneous heart rate,” Biomed. Signal Process. Control, vol. 8, no. 6, pp. 568-574, 2013.
[0088] 36. Y. Zhang et al., “Motion artifact reduction for wrist-worn photoplethysmograph sensors based on different wavelengths,” Sensors, vol. 19, no. 3, p. 673, Feb. 2019.
[0089] 37. A. Taebi and H. A. Mansy, “Time-frequency distribution of seismocardiographic signals: A comparative study,” Bioengineering, vol. 4, no. 2, p. 32, Jun. 2017.
[0090] 38. C. Bruser, J. M. Kortelainen, S. Winter, M. Tenhunen, J. Parkka, and S. Leonhardt, “Improvement of force-sensor-based heart rate estimation using multichannel data fusion,” IEEE J. Biomed. Health Inform., vol. 19, no. 1, pp. 227-235, Jan. 2015.
[0091] 39. T. Y. Euliano et al., “Monitoring fetal heart rate during labor: A comparison of three methods,” J. Pregnancy, vol. 2017, Mar. 2017, Art. no. 8529816.
[0092] 40. W. R. Cohen et al., “Accuracy and reliability of fetal heart rate monitoring using maternal abdominal surface electrodes,” Acta Obstetricia Gynecologica Scandinavica, vol. 91, no. 11, pp. 1306-1313, 2016.
[0093] 41. American Academy of Pediatrics, American College of Obstetricians and Gynecologists Fetal Heart Rate Monitoring, Guidelines for Perinatal Care, 7th ed. Washington, D.C., USA: American College of Obstetricians and Gynecologists, 2012.