Journal
PHYSIOLOGICAL MEASUREMENT
Volume 39, Issue 8, Pages -Publisher
IOP PUBLISHING LTD
DOI: 10.1088/1361-6579/aad4d1
Keywords
Doppler ultrasound; cardiotocography (CTG); fetal monitoring; fetal heart rate (FHR); cardiac time intervals; fetal heart; fetal development
Categories
Funding
- RCUK Digital Economy Programme [EP/G036861/1]
- Oxford Centre for Affordable Healthcare Technology
- National Institutes of Health
- Fogarty International Center
- Eunice Kennedy Shriver National Institute of Child Health and Human Development [1R21HD084114-01]
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One-dimensional Doppler ultrasound (1D-DUS) provides a low-cost and simple method for acquiring a rich signal for use in cardiovascular screening. However, despite the use of 1D-DUS in cardiotocography (CTG) for decades, there are still challenges that limit the effectiveness of its users in reducing fetal and neonatal morbidities and mortalities. This is partly due to the noisy, transient, complex and nonstationary nature of the 1D-DUS signals. Current challenges also include lack of efficient signal quality metrics, insufficient signal processing techniques for extraction of fetal heart rate and other vital parameters with adequate temporal resolution, and lack of appropriate clinical decision support for CTG and Doppler interpretation. Moreover, the almost complete lack of open research in both hardware and software in this field, as well as commercial pressures to market the much more expensive and difficult to use Doppler imaging devices, has hampered innovation. This paper reviews the basics of fetal cardiac function, 1D-DUS signal generation and processing, its application in fetal monitoring and assessment of fetal development and wellbeing. It also provides recommendations for future development of signal processing and modeling approaches, to improve the application of 1D-DUS in fetal monitoring, as well as the need for annotated open databases.
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