Search Results (9)

Maternal and child health during pregnancy is an important issue in global public health, and the classification accuracy of fetal cardiotocography (CTG), as a key tool for monitoring fetal health during pregnancy, is directly related to the effectiveness of early diagnosis and intervention. Due to the serious category imbalance problem of CTG data, traditional models find it challenging to take into account a small number of categories of samples, increasing the risk of leakage and misdiagnosis. To solve this problem, this paper proposes a two-step innovation: firstly, we design a method of adaptive adjustment of misclassification loss function weights (MAAL), which dynamically identifies and increases the focus on misclassified samples based on misclassification rates. Secondly, a primary and secondary correction network model (MAC-NET) is constructed to carry out secondary correction for the misclassified samples of the primary model. Experimental results show that the method proposed in this paper achieves 99.39% accuracy on the UCI publicly available fetal health dataset, and also obtains excellent performance on other domain imbalance datasets. This demonstrates that the model is not only effective in alleviating the problem of category imbalance, but also has very high clinical utility. Full article

Background: Cardiotocography (CTG) is widely used in obstetrics to monitor fetal heart rate and uterine contractions. It helps detect early signs of fetal distress. However, manual interpretation of CTG can be time-consuming and may vary between clinicians. Recent advances in machine learning provide more efficient and consistent alternatives for analyzing CTG data. Objectives: This study aims to investigate the classification of fetal health using various machine learning models to facilitate early detection of fetal health conditions. Methods: This study utilized a tabular dataset comprising 2126 patient records and 21 features. To classify fetal health outcomes, various machine learning algorithms were employed, including CatBoost, Decision Tree, ExtraTrees, Gradient Boosting, KNN, LightGBM, Random Forest, SVM, ANN and DNN. To address class imbalance and enhance model performance, the Synthetic Minority Oversampling Technique (SMOTE) was employed. Results: Among the tested models, the LightGBM algorithm achieved the highest performance, boasting a classification accuracy of 90.73% and, more notably, a balanced accuracy of 91.34%. This superior balanced accuracy highlights LightGBM’s effectiveness in handling imbalanced datasets, outperforming other models in ensuring fair classification across all classes. Conclusions: This study highlights the potential of machine learning models as reliable tools for fetal health classification. The findings emphasize the transformative impact of such technologies on medical diagnostics. Additionally, the use of SMOTE effectively addressed dataset imbalance, further enhancing the reliability and applicability of the proposed approach. Full article

Antepartum Cardiotocography (CTG) is a biomedical sensing technology widely used for fetal health monitoring. While the visual interpretation of CTG traces is highly subjective, with the inter-observer agreement as low as 29% and a false positive rate of approximately 60%, the Dawes–Redman system provides an automated approach to fetal well-being assessments. However, it is primarily designed to rule out adverse outcomes rather than detect them, resulting in a high specificity (90.7%) but low sensitivity (18.2%) in identifying fetal distress. This paper introduces PatchCTG, an AI-enabled biomedical time series transformer for CTG analysis. It employs patch-based tokenisation, instance normalisation, and channel-independent processing to capture essential local and global temporal dependencies within CTG signals. PatchCTG was evaluated on the Oxford Maternity (OXMAT) dataset, which comprises over 20,000 high-quality CTG traces from diverse clinical outcomes, after applying the inclusion and exclusion criteria. With extensive hyperparameter optimisation, PatchCTG achieved an AUC of 0.77, with a specificity of 88% and sensitivity of 57% at Youden’s index threshold, demonstrating its adaptability to various clinical needs. Its robust performance across varying temporal thresholds highlights its potential for both real-time and retrospective analysis in sensor-driven fetal monitoring. Testing across varying temporal thresholds showcased it robust predictive performance, particularly with finetuning on data closer to delivery, achieving a sensitivity of 52% and specificity of 88% for near-delivery cases. These findings suggest the potential of PatchCTG to enhance clinical decision-making in antepartum care by providing a sensor-based, AI-driven, objective tool for reliable fetal health assessment. Full article

Fetal hypoxia is a condition that is caused by insufficient oxygen supply to the fetus and poses serious risks, including abnormalities, birth defects, and potential mortality. Cardiotocography (CTG) monitoring is commonly used to identify fetal distress, including hypoxia, by categorizing cases as normal or hypoxia. However, traditional CTG interpretation, usually performed visually by experts, can be subjective and error-prone, resulting in observer variability and inconsistent outcomes. It highlights the need for an automated and objective diagnostic system to assist clinicians in interpreting CTG data more accurately and consistently. In this research, a fetal hypoxia diagnosis system is proposed based on CTG signals. The CTG dataset is first transformed into the time-frequency domain using instantaneous frequency and using common spatial pattern (CSP) for feature extraction. Finally, the extracted features are then used to train and evaluate four machine learning models for classification with a cross-validation 5-fold methodology. Objective criteria (pH values, BDecf, Apgar 1, and Apgar 5) and expert voting as a subjective criterion were used to classify the fetus as normal or hypoxia. The SVM model outperformed other models in detecting fetal hypoxia, achieving high accuracy across pH, BDecf, Apgar1, Apgar5, and expert voting in all steps. It achieved over 98% accuracy across all objective criteria and steps. Full article

This comprehensive review offers a thorough examination of fetal heart rate (fHR) monitoring methods, which are an essential component of prenatal care for assessing fetal health and identifying possible problems early on. It examines the clinical uses, accuracy, and limitations of both modern and traditional monitoring techniques, such as electrocardiography (ECG), ballistocardiography (BCG), phonocardiography (PCG), and cardiotocography (CTG), in a variety of obstetric scenarios. A particular focus is on the most recent developments in textile-based wearables for fHR monitoring. These innovative devices mark a substantial advancement in the field and are noteworthy for their continuous data collection capability and ergonomic design. The review delves into the obstacles that arise when incorporating these wearables into clinical practice. These challenges include problems with signal quality, user compliance, and data interpretation. Additionally, it looks at how these technologies could improve fetal health surveillance by providing expectant mothers with more individualized and non-intrusive options, which could change the prenatal monitoring landscape. Full article

Cardiotocography (CTG) is widely used to assess fetal well-being. CTG is typically obtained using ultrasound and autocorrelation methods, which extract periodicity from the signal to calculate the heart rate. However, during labor, maternal vessel pulsations can be measured, resulting in the output of the maternal heart rate (MHR). Since the autocorrelation output is displayed as fetal heart rate (FHR), there is a risk that obstetricians may mistakenly evaluate the fetal condition based on MHR, potentially overlooking the necessity for medical intervention. This study proposes a method that utilizes Doppler ultrasound (DUS) signals and artificial intelligence (AI) to determine whether the heart rate obtained by autocorrelation is of fetal origin. We developed a system to simultaneously record DUS signals and CTG and obtained data from 425 cases. The midwife annotated the DUS signals by auditory differentiation, providing data for AI, which included 30,160 data points from the fetal heart and 2160 data points from the maternal vessel. Comparing the classification accuracy of the AI model and a simple mathematical method, the AI model achieved the best performance, with an area under the curve (AUC) of 0.98. Integrating this system into fetal monitoring could provide a new indicator for evaluating CTG quality. Full article

Artificial intelligence (AI) is gaining increasing interest in the field of medicine because of its capacity to process big data and pattern recognition. Cardiotocography (CTG) is widely used for the assessment of foetal well-being and uterine contractions during pregnancy and labour. It is characterised by inter- and intraobserver variability in interpretation, which depends on the observers’ experience. Artificial intelligence (AI)-assisted interpretation could improve its quality and, thus, intrapartal care. Cardiotocography (CTG) raw signals from labouring women were extracted from the database at the University Hospital of Bern between 2006 and 2019. Later, they were matched with the corresponding foetal outcomes, namely arterial umbilical cord pH and 5-min APGAR score. Excluded were deliveries where data were incomplete, as well as multiple births. Clinical data were grouped regarding foetal pH and APGAR score at 5 min after delivery. Physiological foetal pH was defined as 7.15 and above, and a 5-min APGAR score was considered physiologic when reaching ≥7. With these groups, the algorithm was trained to predict foetal hypoxia. Raw data from 19,399 CTG recordings could be exported. This was accomplished by manually searching the patient’s identification numbers (PIDs) and extracting the corresponding raw data from each episode. For some patients, only one episode per pregnancy could be found, whereas for others, up to ten episodes were available. Initially, 3400 corresponding clinical outcomes were found for the 19,399 CTGs (17.52%). Due to the small size, this dataset was rejected, and a new search strategy was elaborated. After further matching and curation, 6141 (31.65%) paired data samples could be extracted (cardiotocography raw data and corresponding maternal and foetal outcomes). Of these, half will be used to train artificial intelligence (AI) algorithms, whereas the other half will be used for analysis of efficacy. Complete data could only be found for one-third of the available population. Yet, to our knowledge, this is the most exhaustive and second-largest cardiotocography database worldwide, which can be used for computer analysis and programming. A further enrichment of the database is planned. Full article

Intrauterine fetal demise in women during pregnancy is a major contributing factor in prenatal mortality and is a major global issue in developing and underdeveloped countries. When an unborn fetus passes away in the womb during the 20th week of pregnancy or later, early detection of the fetus can help reduce the chances of intrauterine fetal demise. Machine learning models such as Decision Trees, Random Forest, SVM Classifier, KNN, Gaussian Naïve Bayes, Adaboost, Gradient Boosting, Voting Classifier, and Neural Networks are trained to determine whether the fetal health is Normal, Suspect, or Pathological. This work uses 22 features related to fetal heart rate obtained from the Cardiotocogram (CTG) clinical procedure for 2126 patients. Our paper focuses on applying various cross-validation techniques, namely, K-Fold, Hold-Out, Leave-One-Out, Leave-P-Out, Monte Carlo, Stratified K-fold, and Repeated K-fold, on the above ML algorithms to enhance them and determine the best performing algorithm. We conducted exploratory data analysis to obtain detailed inferences on the features. Gradient Boosting and Voting Classifier achieved 99% accuracy after applying cross-validation techniques. The dataset used has the dimension of 2126 × 22, and the label is multiclass classified as Normal, Suspect, and Pathological condition. Apart from incorporating cross-validation strategies on several machine learning algorithms, the research paper focuses on Blackbox evaluation, which is an Interpretable Machine Learning Technique used to understand the underlying working mechanism of each model and the means by which it picks features to train and predict values. Full article

Fetal heart rate (FHR) is an important determinant of fetal health. Cardiotocography (CTG) is widely used for measuring the FHR in the clinical field. However, fetal movement and blood flow through the maternal blood vessels can critically influence Doppler ultrasound signals. Moreover, CTG is not suitable for long-term monitoring. Therefore, researchers have been developing algorithms to estimate the FHR using electrocardiograms (ECGs) from the abdomen of pregnant women. However, separating the weak fetal ECG signal from the abdominal ECG signal is a challenging problem. In this paper, we propose a method for estimating the FHR using sequential total variation denoising and compare its performance with that of other single-channel fetal ECG extraction methods via simulation using the Fetal ECG Synthetic Database (FECGSYNDB). Moreover, we used real data from PhysioNet fetal ECG databases for the evaluation of the algorithm performance. The R-peak detection rate is calculated to evaluate the performance of our algorithm. Our approach could not only separate the fetal ECG signals from the abdominal ECG signals but also accurately estimate the FHR. Full article