title: Multidimensional Ultrasound Doppler Signal Analysis for Fetal Activity Monitoring.
abstract: Fetal activity parameters such as movements, heart rate and the related parameters are essential indicators of fetal wellbeing, and no device provides simultaneous access to and sufficient estimation of all of these parameters to evaluate fetal health. This work was aimed at collecting these parameters to automatically separate healthy from compromised fetuses. To achieve this goal, we first developed a multi-sensor-multi-gate Doppler system. Then we recorded multidimensional Doppler signals and estimated the fetal activity parameters via dedicated signal processing techniques. Finally, we combined these parameters into four sets of parameters (or four hyper-parameters) to determine the set of parameters that is able to separate healthy from other fetuses. To validate our system, a data set consisting of two groups of fetal signals (normal and compromised) was established and provided by physicians. From the estimated parameters, an instantaneous Manning-like score, referred to as the ultrasonic score, was calculated and was used together with movements, heart rate and the associated parameters in a classification process employing the support vector machine method. We investigated the influence of the sets of parameters and evaluated the performance of the support vector machine using the computation of sensibility, specificity, percentage of support vectors and total classification error. The sensitivity of the four sets ranged from 79% to 100%. Specificity was 100% for all sets. The total classification error ranged from 0% to 20%. The percentage of support vectors ranged from 33% to 49%. Overall, the best results were obtained with the set of parameters consisting of fetal movement, short-term variability, long-term variability, deceleration and ultrasound score. The sensitivity, specificity, percentage of support vectors and total classification error of this set were respectively 100%, 100%, 35% and 0%. This indicated our ability to separate the data into two sets (normal fetuses and pathologic fetuses), and the results highlight the excellent match with the clinical classification performed by the physicians. This work indicates the feasibility of detecting compromised fetuses and also represents an interesting method of close fetal monitoring during the entire pregnancy.
authors.affiliation: University of Toulouse III, IRIT UMR CNRS 5505, Toulouse, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Ribes
authors.affiliation: University of Tours, INSERM U930 Tours, France.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Girault
authors.affiliation: CHU Bretonneau, Tours, service de Gynecologie Obstétrique, INSERM U930, Tours, France.
authors.forename: Franck
authors.initials: F
authors.lastname: Perrotin
authors.affiliation: University of Toulouse III, IRIT UMR CNRS 5505, Toulouse, France. Electronic address: kouame@irit.fr.
authors.forename: Denis
authors.initials: D
authors.lastname: Kouamé
mesh_terms: D000328:Adult; D015150:Echocardiography, Doppler; D005240:Feasibility Studies; D005260:Female; D005323:Fetal Monitoring; D005324:Fetal Movement / Q000502:physiology*; D006340:Heart Rate, Fetal / Q000502:physiology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D011247:Pregnancy; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted; D060388:Support Vector Machine; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D055815:Young Adult
keywords: Fetal heart rhythm; Fetal monitoring; Fetal movement; Multidimensional signals; Support vector machine