Adaptive Multiscale Complexity Analysis of Fetal Heart Rate

Per partum fetal asphyxia is a major cause of neonatal morbidity and mortality. Fetal heart rate monitoring plays an important role in early detection of acidosis, an indicator for asphyxia. This problem is addressed in this paper by introducing a novel complexity analysis of fetal heart rate data, based on producing a collection of piecewise linear approximations of varying dimensions from which a measure of complexity is extracted. This procedure specifically accounts for the highly nonstationary context of labor by being adaptive and multiscale. Using a reference dataset, made of real per partum fetal heart rate data, collected in situ and carefully constituted by obstetricians, the behavior of the proposed approach is analyzed and illustrated. Its performance is evaluated in terms of the rate of correct acidosis detection versus the rate of false detection, as well as how early the detection is made. Computational cost is also discussed. The results are shown to be extremely promising and further potential uses of the tool are discussed. MATLAB routines implementing the procedure will be made available at the time of publication.

[1]  J. Low,et al.  Predictive value of electronic fetal monitoring for intrapartum fetal asphyxia with metabolic acidosis. , 1999, Obstetrics and gynecology.

[2]  Ravindra K. Ahuja,et al.  Network Flows: Theory, Algorithms, and Applications , 1993 .

[3]  Sergio Cerutti,et al.  Linear and nonlinear parameters for the analysisof fetal heart rate signal from cardiotocographic recordings , 2003, IEEE Transactions on Biomedical Engineering.

[4]  D. Reddihough,et al.  The epidemiology and causes of cerebral palsy. , 2003, The Australian journal of physiotherapy.

[5]  B. Sibai,et al.  Maternal Morbidity Associated With Multiple Repeat Cesarean Deliveries , 2006, Obstetrics and gynecology.

[6]  Toru Nakamura,et al.  Local Holder exponent analysis of heart rate variability in preterm infants , 2006, IEEE Transactions on Biomedical Engineering.

[7]  Steve N Caritis,et al.  Elective single-embryo transfer versus double-embryo transfer in in vitro fertilization , 2004, The New England journal of medicine.

[8]  Jason K Baxter,et al.  Fetal injury associated with cesarean delivery. , 2007, Obstetrics and gynecology.

[9]  J. S. Detwiler,et al.  Statistical Modeling of Fetal Heart Rate Variability , 1980, IEEE Transactions on Biomedical Engineering.

[10]  Scale-Invariant Aspects of Cardiac Dynamics , 2022 .

[11]  E. Ifeachor,et al.  A Comparative Study of Fetal Heart Rate Variability Analysis Techniques , 2006, 2006 International Conference of the IEEE Engineering in Medicine and Biology Society.

[12]  Sergio Cerutti,et al.  Comparison of entropy-based regularity estimators: application to the fetal heart rate signal for the identification of fetal distress , 2006, IEEE Transactions on Biomedical Engineering.

[13]  Yoshiharu Yamamoto,et al.  Multiscale probability density function analysis: non-Gaussian and scale-Invariant fluctuations of healthy human heart rate , 2006, IEEE Transactions on Biomedical Engineering.

[14]  Z. Alfirevic,et al.  Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour. , 2006, The Cochrane database of systematic reviews.

[15]  Zbigniew R. Struzik,et al.  Revealing local variability properties of human heartbeat intervals with the local effective Hölder exponent , 2000 .

[16]  Michael G Ross,et al.  The 2008 National Institute of Child Health and Human Development workshop report on electronic fetal monitoring: update on definitions, interpretation, and research guidelines. , 2009, Obstetrics and gynecology.

[17]  W. Marsden I and J , 2012 .

[18]  C. Spong,et al.  The 2008 National Institute of Child Health and Human Development workshop report on electronic fetal monitoring: update on definitions, interpretation, and research guidelines. , 2008, Journal of obstetric, gynecologic, and neonatal nursing : JOGNN.

[19]  P. Ivanov Scale-invariant Aspects of Cardiac Dynamics Across Sleep Stages and Circadian Phases , 2007, 2006 International Conference of the IEEE Engineering in Medicine and Biology Society.

[20]  Emmanuel J. Candes,et al.  Detecting highly oscillatory signals by chirplet path pursuit , 2006, gr-qc/0604017.

[21]  J. V. van Laar,et al.  Spectral analysis of fetal heart rate variability for fetal surveillance: review of the literature , 2008, Acta obstetricia et gynecologica Scandinavica.

[22]  H. Helgason,et al.  Nonparametric Detection and Estimation of Highly Oscillatory Signals , 2008 .

[23]  Paulo Gonçalves,et al.  Multifractal analysis of ECG for intrapartum diagnosis of fetal asphyxia , 2010, 2010 IEEE International Conference on Acoustics, Speech and Signal Processing.

[24]  H. Joksch The shortest route problem with constraints , 1966 .

[25]  E. Brown,et al.  A point-process model of human heartbeat intervals: new definitions of heart rate and heart rate variability. , 2005, American journal of physiology. Heart and circulatory physiology.

[26]  Ravindra K. Ahuja,et al.  Network Flows , 2011 .

[27]  Steve N Caritis,et al.  Fetal Injury Associated With Cesarean Delivery , 2006, Obstetrics and gynecology.

[28]  G S Dawes,et al.  Improvements in the registration and analysis of fetal heart rate records at the bedside , 1985, British journal of obstetrics and gynaecology.

[29]  Patrice Abry,et al.  Multifractal analysis of fetal heart rate variability in fetuses with and without severe acidosis during labor. , 2011, American journal of perinatology.

[30]  J M Dambrosia,et al.  Uncertain value of electronic fetal monitoring in predicting cerebral palsy. , 1996, The New England journal of medicine.

[31]  Eric R. Ziegel,et al.  The Elements of Statistical Learning , 2003, Technometrics.