Passive detection of accelerometer-recorded fetal movements using a time-frequency signal processing approach

This paper describes a multi-sensor fetal movement (FetMov) detection system based on a time-frequency (TF) signal processing approach. Fetal motor activity is clinically useful as a core aspect of fetal screening for well-being to reduce the current high incidence of fetal deaths in the world. FetMov are present in early gestation but become more complex and sustained as the fetus progresses through gestation. A decrease in FetMov is an important element to consider for the detection of fetal compromise. Current methods of FetMov detection include maternal perception, which is known to be inaccurate, and ultrasound imaging which is intrusive and costly. An alternative passive method for the detection of FetMov uses solid-state accelerometers, which are safe and inexpensive. This paper describes a digital signal processing (DSP) based experimental approach to the detection of FetMov from recorded accelerometer signals. The paper provides an overview of the significant measurement and signal processing challenges, followed by an approach that uses quadratic time-frequency distributions (TFDs) to appropriately deal with the non-stationary nature of the signals. The paper then describes a proof-of-concept with a solution consisting of a detection method that includes (1) a new experimental set-up, (2) an improved data acquisition procedure, and (3) a TF approach for the detection of FetMov including TF matching pursuit (TFMP) decomposition and TF matched filter (TFMF) based on high-resolution quadratic TFDs. Detailed suggestions for further refinement are provided with preliminary results to establish feasibility, and considerations for application to clinical practice are reviewed.

[1]  Tamara Stampalija,et al.  Utero-placental Doppler ultrasound for improving pregnancy outcome. , 2010, The Cochrane database of systematic reviews.

[2]  Kyoko Nishihara,et al.  A new method for long-term home monitoring of fetal movement by pregnant women themselves. , 2012, Medical engineering & physics.

[3]  J. Low,et al.  Limitations in the clinical prediction of intrapartum fetal asphyxia. , 1995, American journal of obstetrics and gynecology.

[4]  Stéphane Mallat,et al.  Matching pursuits with time-frequency dictionaries , 1993, IEEE Trans. Signal Process..

[5]  Annemarie Hennessy,et al.  Treatment of sleep disordered breathing reverses low fetal activity levels in preeclampsia. , 2013, Sleep.

[6]  J Frederik Frøen,et al.  A kick from within – fetal movement counting and the cancelled progress in antenatal care , 2004, Journal of perinatal medicine.

[7]  G. Visser,et al.  The emergence of fetal behaviour. III. Individual differences and consistencies. , 1988, Early human development.

[8]  H. Prechtl,et al.  Assessment of the quality of general movements in fetuses and infants of women with type-I diabetes mellitus. , 1997, Early human development.

[9]  Boualem Boashash,et al.  Estimating and interpreting the instantaneous frequency of a signal. I. Fundamentals , 1992, Proc. IEEE.

[10]  A. Bocking,et al.  Assessment of fetal heart rate and fetal movements in detecting oxygen deprivation in-utero. , 2003, European journal of obstetrics, gynecology, and reproductive biology.

[11]  T. Thayaparan.  Time-Frequency Signal Analysis , 2014 .

[12]  C. East,et al.  Maternal perception of foetal movement compared with movement detected by real‐time ultrasound: An exploratory study , 2010, The Australian & New Zealand journal of obstetrics & gynaecology.

[13]  Boualem Boashash,et al.  Time-Frequency Signal Analysis and Processing: A Comprehensive Reference , 2015 .

[14]  Mostefa Mesbah,et al.  A matching pursuit-based signal complexity measure for the analysis of newborn EEG , 2007, Medical & Biological Engineering & Computing.

[15]  Akaysha Tang,et al.  Applications of Second Order Blind Identification to High-Density EEG-Based Brain Imaging: A Review , 2010, ISNN.

[16]  Boualem Boashash,et al.  Design of a high-resolution separable-kernel quadratic TFD for improving newborn health outcomes using fetal movement detection , 2012, 2012 11th International Conference on Information Science, Signal Processing and their Applications (ISSPA).

[17]  Boualem Boashash,et al.  An efficient real-time implementation of the Wigner-Ville distribution , 1987, IEEE Trans. Acoust. Speech Signal Process..

[18]  Saad Siddiqui,et al.  Screening and triage of intrauterine growth restriction (IUGR) in general population and high risk pregnancies: a systematic review with a focus on reduction of IUGR related stillbirths , 2011, BMC public health.

[19]  M G Rosen,et al.  Classification of human fetal movement. , 1976, American Journal of Obstetrics and Gynecology.

[20]  Boualem Boashash,et al.  Algorithms for Time-Frequency Signal Analysis , 1992 .

[21]  K Marsál,et al.  Ultrasonic assessment of fetal activity. , 1983, Clinics in obstetrics and gynaecology.

[22]  Majid Ezzati,et al.  Stillbirths: the way forward in high-income countries , 2011, The Lancet.

[23]  G. Visser,et al.  Motor behaviour in the growth retarded fetus. , 1985, Early human development.

[24]  Bernhard Laback,et al.  Time–Frequency Sparsity by Removing Perceptually Irrelevant Components Using a Simple Model of Simultaneous Masking , 2010, IEEE Transactions on Audio, Speech, and Language Processing.

[25]  Boualem Boashash,et al.  Methods of signal classification using the images produced by the Wigner-Ville distribution , 1991, Pattern Recognit. Lett..

[26]  G. Mello,et al.  Stillbirth and fetal growth restriction , 2013, The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians.

[27]  Mohamed Ibnkahla,et al.  Signal Processing for Mobile Communications Handbook , 2004 .

[28]  Babill Stray-Pedersen,et al.  Reduction of late stillbirth with the introduction of fetal movement information and guidelines – a clinical quality improvement , 2009, BMC pregnancy and childbirth.

[29]  B. Stray-Pedersen,et al.  Restricted fetal growth in sudden intrauterine unexplained death , 2004, Acta obstetricia et gynecologica Scandinavica.

[30]  Boualem Boashash,et al.  The T-class of time-frequency distributions: Time-only kernels with amplitude estimation , 2006, J. Frankl. Inst..

[31]  Rayburn Wf.  Fetal body movement monitoring. , 1990 .

[32]  N. Pattison,et al.  Cardiotocography for antepartum fetal assessment. , 2010, The Cochrane database of systematic reviews.

[33]  B. Boashash,et al.  Effective implementation of time-frequency matched filter with adapted pre and postprocessing for data-dependent detection of newborn seizures. , 2013, Medical engineering & physics.

[34]  Holger Rauhut,et al.  Sparsity in Time-Frequency Representations , 2007, ArXiv.

[35]  John M. O'Toole,et al.  Time-Frequency Processing of Nonstationary Signals: Advanced TFD Design to Aid Diagnosis with Highlights from Medical Applications , 2013, IEEE Signal Processing Magazine.

[36]  Shigeko Horiuchi,et al.  A long-term monitoring of fetal movement at home using a newly developed sensor: an introduction of maternal micro-arousals evoked by fetal movement during maternal sleep. , 2008, Early human development.

[37]  B. Richardson,et al.  Electrocortical activity, electroocular activity, and breathing movements in fetal sheep with prolonged and graded hypoxemia. , 1992, American journal of obstetrics and gynecology.

[38]  Abbes Amira,et al.  High level prototyping and FPGA implementation of the orthogonal matching pursuit algorithm , 2012, 2012 11th International Conference on Information Science, Signal Processing and their Applications (ISSPA).

[39]  Boualem Boashash,et al.  A comparison of quadratic TFDs for entropy based detection of components time supports in multicomponent nonstationary signal mixtures , 2013, 2013 8th International Workshop on Systems, Signal Processing and their Applications (WoSSPA).

[40]  T S Patrelli,et al.  Correlation between fetal movement revealed in actography and fetal-neonatal well-being: observational study on 3,805 pregnancies followed in a Northern Italy tertiary care hospital. , 2011, Clinical and experimental obstetrics & gynecology.

[41]  N. Pattison,et al.  WITHDRAWN. Cardiotocography for antepartum fetal assessment. , 2010, The Cochrane database of systematic reviews.

[42]  G. Lingman,et al.  A critical appraisal of the use of umbilical artery Doppler ultrasound in high‐risk pregnancies: use of meta‐analyses in evidence‐based obstetrics , 2001, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology.

[43]  Vicki Flenady,et al.  Stillbirths: the vision for 2020 , 2011, The Lancet.

[44]  Boualem Boashash,et al.  Estimating and interpreting the instantaneous frequency of a signal. II. A/lgorithms and applications , 1992, Proc. IEEE.

[45]  G. Visser,et al.  The effect of intrauterine growth retardation on the quality of general movements in the human fetus. , 1992, Early human development.

[46]  Vicki Flenady,et al.  Analysis of ‘count‐to‐ten’ fetal movement charts: a prospective cohort study , 2011, BJOG : an international journal of obstetrics and gynaecology.

[47]  Boualem Boashash,et al.  Separation of nonstationary EEG epileptic seizures using time-frequency-based blind signal processing techniques , 2013 .

[48]  Anette G. Olesen,et al.  Decreased fetal movements: background, assessment, and clinical management , 2004, Acta obstetricia et gynecologica Scandinavica.

[49]  Babill Stray-Pedersen,et al.  Concerns for decreased foetal movements in uncomplicated pregnancies – Increased risk of foetal growth restriction and stillbirth among women being overweight, advanced age or smoking , 2010, The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians.

[50]  Boualem Boashash,et al.  On the Selection of Time-Frequency Features for Improving the Detection and Classification of Newborn EEG Seizure Signals and Other Abnormalities , 2012, ICONIP.

[51]  Boualem Boashash,et al.  Time-Frequency Signal Processing for Wireless Communications , 2005 .

[52]  H. G. Goovaerts,et al.  A comparative clinical study of fetal phono- and movement-sensors from Amsterdam, Cambridge and Edinburgh. , 1991, Journal of biomedical engineering.

[53]  W. Rayburn,et al.  Antenatal evaluation of the fetus using fetal movement monitoring. , 2002, Clinical obstetrics and gynecology.

[54]  John M. O'Toole,et al.  Time-Frequency Detection of Slowly Varying Periodic Signals with Harmonics: Methods and Performance Evaluation , 2011, EURASIP J. Adv. Signal Process..

[55]  Babill Stray-Pedersen,et al.  Correction: Reduction of late stillbirth with the introduction of fetal movement information and guidelines - a clinical quality improvement , 2010, BMC Pregnancy and Childbirth.

[56]  Boualem Boashash,et al.  A passive DSP approach to fetal movement detection for monitoring fetal health , 2012, 2012 11th International Conference on Information Science, Signal Processing and their Applications (ISSPA).

[57]  Braham Barkat,et al.  A high-resolution quadratic time-frequency distribution for multicomponent signals analysis , 2001, IEEE Trans. Signal Process..

[58]  Asad Malik,et al.  Maternal and fetal risk factors for stillbirth: population based study , 2013, BMJ.

[59]  G Cioni,et al.  The qualitative assessment of general movements in preterm, term and young infants--review of the methodology. , 1997, Early human development.

[60]  C. East,et al.  Factors Affecting Maternal Perception of Fetal Movement , 2009, Obstetrical & gynecological survey.

[61]  Boualem Boashash,et al.  A methodology for detection and classification of some underwater acoustic signals using time-frequency analysis techniques , 1990, IEEE Trans. Acoust. Speech Signal Process..

[62]  J. Boué,et al.  Ultrasound movement patterns of fetuses with chromosome anomalies , 1982 .

[63]  G. Visser,et al.  Quantitative analysis of fetal general movements: methodological considerations. , 1999, Early human development.