Antepartum non-invasive evaluation of opening and closing timings of the cardiac valves in fetal cardiac cycle

In this study, we propose a non-invasive algorithm to recognize the timings of fetal cardiac events on the basis of analysis of fetal ECG (FECG) and Doppler ultrasound signals. Multiresolution wavelet analysis enabled the frequency contents of the Doppler signals to be linked to the opening (o) and closing (c) of the heart’s valves (Aortic (A) and Mitral (M)). M-mode, B-mode and pulsed Doppler ultrasound were used to verify the timings of opening and closure of these valves. In normal fetuses, the time intervals from Q-wave of QRS complex of FECG to opening and closing of aortic valve, i.e., Q-Ao and Q-Ac were found to be 79.3 ± 17.4 and 224.7 ± 13.3 ms, respectively. For the mitral valve, Q-Mc and Q-Mo were found to be 27.7 ± 9.4 and 294.6 ± 21.3 ms, respectively. Correlations among the timings in opening and closing of cardiac valves were found to be higher in abnormal fetuses than that in normal ones.

[1]  Ana Paula Rocha,et al.  Linear and nonlinear fetal heart rate analysis of normal and acidemic fetuses in the minutes preceding delivery , 2006, Medical and Biological Engineering and Computing.

[2]  A. Weissler,et al.  Systolic Time Intervals in Heart Failure in Man , 1968, Circulation.

[3]  J. Wladimiroff,et al.  Assessment of fetal left cardiac isovolumic relaxation time in appropriate and small-for-gestational-age fetuses. , 1995, Ultrasound in medicine & biology.

[4]  Takuya Ito,et al.  A Novel Extraction Method of Fetal Electrocardiogram From the Composite Abdominal Signal , 2007, IEEE Transactions on Biomedical Engineering.

[5]  J. Wrobel,et al.  Timing events in Doppler ultrasound signal of fetal heart activity , 2004, The 26th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[6]  L. W. Perry,et al.  Congenital heart disease: prevalence at livebirth. The Baltimore-Washington Infant Study. , 1985, American journal of epidemiology.

[7]  J Kachaner,et al.  Detection of transposition of the great arteries in fetuses reduces neonatal morbidity and mortality. , 1999, Circulation.

[8]  J Morgenstern,et al.  Systolic time intervals of the fetal cardiac cycle. , 1978, Journal of perinatal medicine.

[9]  Maria G. Signorini,et al.  Complexity analysis of the fetal heart rate variability: early identification of severe intrauterine growth-restricted fetuses , 2009, Medical & Biological Engineering & Computing.

[10]  R. Goodlin,et al.  Systolic Time Intervals in the Fetus and Neonate , 1972, Obstetrics and gynecology.

[11]  M Vigliani.  Romano-Ward syndrome diagnosed as moderate fetal bradycardia. A case report. , 1995, The Journal of reproductive medicine.

[12]  Lei Wang,et al.  26th Annual International Conference of the IEEE EMBS , 2004 .

[13]  L W Organ,et al.  Fetal preejection period. , 1982, Obstetrics and gynecology.

[14]  J. Wrobel,et al.  Instrumentation for Fetal Cardiac Performance Analysis During the Antepartum Period , 2005, 2005 IEEE Engineering in Medicine and Biology 27th Annual Conference.

[15]  P. Schwartz,et al.  The long QT syndrome. , 1997, Current problems in cardiology.

[16]  M. Hofbeck,et al.  Prenatal findings in patients with prolonged QT interval in the neonatal period. , 1997, Heart.

[17]  N Athayde,et al.  A new and simple Doppler method for measurement of fetal cardiac isovolumetric contraction time , 2001, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology.

[18]  J. A. Crowe,et al.  The information content of Doppler ultrasound signals from the fetal heart , 2001, Medical and Biological Engineering and Computing.