Novel Hybrid Extraction Systems for Fetal Heart Rate Variability Monitoring Based on Non-Invasive Fetal Electrocardiogram

This study focuses on the design, implementation and subsequent verification of a new type of hybrid extraction system for noninvasive fetal electrocardiogram (NI-fECG) processing. The system designed combines the advantages of individual adaptive and non-adaptive algorithms. The pilot study reviews two innovative hybrid systems called ICA-ANFIS-WT and ICA-RLS-WT. This is a combination of independent component analysis (ICA), adaptive neuro-fuzzy inference system (ANFIS) algorithm or recursive least squares (RLS) algorithm and wavelet transform (WT) algorithm. The study was conducted on clinical practice data (extended ADFECGDB database and Physionet Challenge 2013 database) from the perspective of non-invasive fetal heart rate variability monitoring based on the determination of the overall probability of correct detection (ACC), sensitivity (SE), positive predictive value (PPV) and harmonic mean between SE and PPV (F1). System functionality was verified against a relevant reference obtained by an invasive way using a scalp electrode (ADFECGDB database), or relevant reference obtained by annotations (Physionet Challenge 2013 database). The study showed that ICA-RLS-WT hybrid system achieve better results than ICA-ANFIS-WT. During experiment on ADFECGDB database, the ICA-RLS-WT hybrid system reached ACC > 80 % on 9 recordings out of 12 and the ICA-ANFIS-WT hybrid system reached ACC > 80 % only on 6 recordings out of 12. During experiment on Physionet Challenge 2013 database the ICA-RLS-WT hybrid system reached ACC > 80 % on 13 recordings out of 25 and the ICA-ANFIS-WT hybrid system reached ACC > 80 % only on 7 recordings out of 25. Both hybrid systems achieve provably better results than the individual algorithms tested in previous studies.

[1]  Jonathon A. Chambers,et al.  Fetal electrocardiogram extraction by sequential source separation in the wavelet domain , 2005, IEEE Transactions on Biomedical Engineering.

[2]  Paul J. Werbos,et al.  Backpropagation Through Time: What It Does and How to Do It , 1990, Proc. IEEE.

[3]  Ramesh Kumar Sunkaria,et al.  Comparative study of fetal ECG elicitation using adaptive filtering techniques , 2016, 2016 2nd International Conference on Advances in Electrical, Electronics, Information, Communication and Bio-Informatics (AEEICB).

[4]  K. Maršál,et al.  Cardiotocography only versus cardiotocography plus ST analysis of fetal electrocardiogram for intrapartum fetal monitoring: a Swedish randomised controlled trial , 2001, The Lancet.

[5]  C. Martin Electronic fetal monitoring: a brief summary of its development, problems and prospects. , 1998, European journal of obstetrics, gynecology, and reproductive biology.

[6]  Klaas Wijma,et al.  Posttraumatic stress reactions after emergency cesarean section , 1997, Acta obstetricia et gynecologica Scandinavica.

[7]  Dongfang Luo Research and Application of Fetal Electrocardiogram Blind Signal Separation Technology , 2012 .

[8]  Rik Vullings,et al.  An Adaptive Kalman Filter for ECG Signal Enhancement , 2011, IEEE Transactions on Biomedical Engineering.

[9]  Janusz Jezewski,et al.  Towards noise immune detection of fetal QRS complexes , 2010, Comput. Methods Programs Biomed..

[10]  K. Assaleh Adaptive Neuro-Fuzzy Inference Systems for Extracting Fetal Electrocardiogram , 2006, 2006 IEEE International Symposium on Signal Processing and Information Technology.

[11]  K. Helen Prabha,et al.  Fetal Electrocardiogram Extraction Using Adaptive Neuro-fuzzy Inference Systems and Undecimated Wavelet Transform , 2012 .

[12]  Radek Martinek,et al.  Adaptive Linear Neuron for Fetal Electrocardiogram Extraction , 2018, 2018 IEEE 20th International Conference on e-Health Networking, Applications and Services (Healthcom).

[13]  G. Visser,et al.  A validation of electrohysterography for uterine activity monitoring during labour , 2009, 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.

[14]  Reza Sameni,et al.  Fetal R-wave detection from multichannel abdominal ECG recordings in low SNR , 2009, 2009 Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[15]  Lucia Billeci,et al.  A Combined Independent Source Separation and Quality Index Optimization Method for Fetal ECG Extraction from Abdominal Maternal Leads , 2017, Sensors.

[16]  Richard H. Paul,et al.  Clinical fetal monitoring: its effect on cesarean section rate and perinatal mortality: five-year trends. , 1977, Postgraduate medicine.

[17]  Alberto J. Palma,et al.  Efficient wavelet-based ECG processing for single-lead FHR extraction , 2013, Digit. Signal Process..

[18]  Susana Hornillo-Mellado,et al.  Fast Technique for Noninvasive Fetal ECG Extraction , 2011, IEEE Transactions on Biomedical Engineering.

[19]  J. Jezewski,et al.  Application of spatio-temporal filtering to fetal electrocardiogram enhancement , 2011, Comput. Methods Programs Biomed..

[20]  S Petrou,et al.  Economic aspects of caesarean section and alternative modes of delivery. , 2001, Best practice & research. Clinical obstetrics & gynaecology.

[21]  Janusz Jezewski,et al.  Comparison of Doppler ultrasound and direct electrocardiography acquisition techniques for quantification of fetal heart rate variability , 2006, IEEE Transactions on Biomedical Engineering.

[22]  Khaled Assaleh,et al.  Extraction of Fetal Electrocardiogram Using Adaptive Neuro-Fuzzy Inference Systems , 2007, IEEE Transactions on Biomedical Engineering.

[23]  M G Ross,et al.  ST-segment analysis of the fetal electrocardiogram improves fetal heart rate tracing interpretation and clinical decision making , 2004, 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.

[24]  G. Camps,et al.  Fetal ECG extraction using an FIR neural network , 2001, Computers in Cardiology 2001. Vol.28 (Cat. No.01CH37287).

[25]  E Bacharakis,et al.  Maternal and foetal ECG separation using blind source separation methods. , 1997, IMA journal of mathematics applied in medicine and biology.

[26]  Francesco Carlo Morabito,et al.  A new approach based on wavelet-ICA algorithms for fetal electrocardiogram extraction , 2005, ESANN.

[27]  Lotfi A. Zadeh,et al.  Soft computing and fuzzy logic , 1994, IEEE Software.

[28]  Pradeep Kumar,et al.  Detection of fetal electrocardiogram through OFDM, neuro- fuzzy logic and wavelets systems for telemetry , 2015 .

[29]  S R Rathod,et al.  Separation of FECG from complex ECG in fetal monitoring , 2016, 2016 Online International Conference on Green Engineering and Technologies (IC-GET).

[30]  Lei Peng,et al.  A fast and adaptive ICA algorithm with its application to fetal electrocardiogram extraction , 2008, Appl. Math. Comput..

[31]  Radek Martinek,et al.  Non-Adaptive Methods for Fetal ECG Signal Processing: A Review and Appraisal , 2018, Sensors.

[32]  Joachim Behar,et al.  Extraction of clinical information from the non-invasive fetal electrocardiogram , 2016, ArXiv.

[33]  S. Suja Priyadharsini,et al.  An Efficient Soft-Computing Technique for Extracting Fetal ECG from Maternal ECG Signal , 2011 .

[34]  Jan Nedoma,et al.  Fetal ECG Preprocessing Using Wavelet Transform , 2018, ICCMS.

[35]  A. Immanuel Selvakumar,et al.  Issues and research on foetal electrocardiogram signal elicitation , 2014, Biomed. Signal Process. Control..

[36]  Ellen Kopel Zottoli,et al.  Electronic Fetal Monitoring: Concepts and Applications , 2001 .

[37]  Mamun Bin Ibne Reaz,et al.  Fetal ECG Extraction from Maternal Abdominal ECG Using Neural Network , 2009, J. Softw. Eng. Appl..

[38]  Marian F MacDorman,et al.  Fetal and perinatal mortality, United States, 2004. , 2007, National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System.

[39]  Hernâni Gonçalves,et al.  Fetal QRS detection and heart rate estimation: a wavelet-based approach. , 2014, Physiological measurement.

[40]  Ee-Chien Chang,et al.  Blind separation of fetal ECG from single mixture using SVD and ICA , 2003, Fourth International Conference on Information, Communications and Signal Processing, 2003 and the Fourth Pacific Rim Conference on Multimedia. Proceedings of the 2003 Joint.

[41]  Yiyao Ye-Lin,et al.  Automatic Identification of Motion Artifacts in EHG Recording for Robust Analysis of Uterine Contractions , 2014, Comput. Math. Methods Medicine.

[42]  Rubén Martín-Clemente,et al.  The Maternal Abdominal ECG as Input to MICA in the Fetal ECG Extraction Problem , 2011, IEEE Signal Processing Letters.

[43]  S. Thacker,et al.  Historical Controversy in Health Technology Assessment:: The Case of Electronic Fetal Monitoring , 2001, Obstetrical & gynecological survey.

[44]  Joos Vandewalle,et al.  Fetal electrocardiogram extraction by blind source subspace separation , 2000, IEEE Transactions on Biomedical Engineering.

[45]  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.

[46]  N. Wessel,et al.  Fetal QRS Detection by means of Kalman Filtering and using the Event Synchronous Canceller , 2012 .

[47]  K. Bommanna Raja,et al.  Fetal ECG extraction and enhancement in prenatal monitoring — Review and implementation issues , 2010, Trendz in Information Sciences & Computing(TISC2010).

[48]  Yanjun Zeng,et al.  Research of fetal ECG extraction using wavelet analysis and adaptive filtering , 2013, Comput. Biol. Medicine.

[49]  Wei Zheng,et al.  Noninvasive fetal ECG estimation using adaptive comb filter , 2013, Comput. Methods Programs Biomed..

[50]  Asoke K. Nandi,et al.  Noninvasive fetal electrocardiogram extraction: blind separation versus adaptive noise cancellation , 2001, IEEE Transactions on Biomedical Engineering.

[51]  E. M. Graatsma Monitoring of fetal heart rate and uterine activity , 2010 .

[52]  R L Williams,et al.  Cesarean section, fetal monitoring, and perinatal mortality in California. , 1979, American journal of public health.

[53]  Hasan Al-Nashash,et al.  A novel technique for the extraction of fetal ECG using polynomial networks , 2005, IEEE Transactions on Biomedical Engineering.

[54]  D. Altman,et al.  Measuring agreement in method comparison studies , 1999, Statistical methods in medical research.

[55]  S. Thacker,et al.  Costs and Benefits of Electronic Fetal 1-1 Monitoring : A Review of the Literature , 2022 .

[56]  F. Mochimaru,et al.  Detecting the Fetal Electrocardiogram by Wavelet Theory-Based Methods , 2022 .

[57]  Adam Gacek,et al.  The influence of coincidence of fetal and maternal QRS complexes on fetal heart rate reliability , 2006, Medical and Biological Engineering and Computing.

[58]  G. Clifford,et al.  Evaluation of the fetal QT interval using non-invasive fetal ECG technology , 2016, Physiological measurement.

[59]  Antonio R. Damasio,et al.  Knowledge systems , 1992, Current Opinion in Neurobiology.

[60]  K. Wijma,et al.  Psychological impact of emergency cesarean section in comparison with elective cesarean section, instrumental and normal vaginal delivery. , 1998, Journal of psychosomatic obstetrics and gynaecology.

[61]  R. Swarnalath,et al.  A Novel Technique for Extraction of FECG using Multi Stage Adaptive Filtering , 2010 .

[62]  Janusz Jezewski,et al.  Detection of low amplitude fetal QRS complexes , 2008, 2008 30th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[63]  C. Li,et al.  Detection of ECG characteristic points using wavelet transforms. , 1995, IEEE transactions on bio-medical engineering.

[64]  L. Moore,et al.  Uterine artery blood flow, fetal hypoxia and fetal growth , 2015, Philosophical Transactions of the Royal Society B: Biological Sciences.

[65]  Michael S. Burnhill,et al.  Fetal Electrocardiography: The Electrical Activity of the Fetal Heart , 1961 .

[66]  D. Fotiadis,et al.  Fetal heart rate extraction from composite maternal ECG using complex continuous wavelet transform , 2004, Computers in Cardiology, 2004.

[67]  Chunlan Yang,et al.  Fetal ECG extraction based on adaptive linear neural network , 2010, 2010 3rd International Conference on Biomedical Engineering and Informatics.

[68]  G. Saha,et al.  Fetal ECG extraction from single-channel maternal ECG using singular value decomposition , 1997, IEEE Transactions on Biomedical Engineering.

[69]  Karim Faez,et al.  A new method for extraction of fetal electrocardiogram signal based on Adaptive Nero-Fuzzy Inference System , 2011, 2011 IEEE International Conference on Signal and Image Processing Applications (ICSIPA).

[70]  Yan Huawen,et al.  Automatic identifying of maternal ECG source when applying ICA in fetal ECG extraction , 2018 .

[71]  C. Jutten,et al.  What ICA Provides for ECG Processing: Application to Noninvasive Fetal ECG Extraction , 2006, 2006 IEEE International Symposium on Signal Processing and Information Technology.

[72]  Tahira Kazmi,et al.  ST Analysis of the Fetal ECG, as an Adjunct to Fetal Heart Rate Monitoring in Labour: A Review. , 2011, Oman medical journal.

[73]  S. Thacker,et al.  EFFICACY AND SAFETY OF INTRAPARTUM ELECTRONIC FETAL MONITORING: AN UPDATE , 1995, Obstetrics and gynecology.

[74]  G. Saade,et al.  A Randomized Trial of Intrapartum Fetal ECG ST-Segment Analysis , 2015 .

[75]  Erkki Oja,et al.  Independent component analysis: algorithms and applications , 2000, Neural Networks.

[76]  Janusz Jezewski,et al.  Determination of fetal heart rate from abdominal signals: evaluation of beat-to-beat accuracy in relation to the direct fetal electrocardiogram , 2012, Biomedizinische Technik. Biomedical engineering.

[77]  Shahriar Negahdaripour,et al.  A new method for the extraction of fetal ECG from the composite abdominal signal , 2000, IEEE Transactions on Biomedical Engineering.

[78]  G. Boudreaux-Bartels,et al.  Wavelet transform-based QRS complex detector , 1999, IEEE Transactions on Biomedical Engineering.

[79]  Daniel F. Valencia,et al.  Comparison analysis between rigrsure, sqtwolog, heursure and minimaxi techniques using hard and soft thresholding methods , 2016, 2016 XXI Symposium on Signal Processing, Images and Artificial Vision (STSIVA).

[80]  E. Hon,et al.  THE FETAL ELECTROCARDIOGRAM. V. COMPARISON OF LEAD SYSTEMS. , 1965, American journal of obstetrics and gynecology.

[81]  Stavros Petrou,et al.  Systematic review of economic aspects of alternative modes of delivery , 2001, BJOG : an international journal of obstetrics and gynaecology.

[82]  Radek Martinek,et al.  Fetal ECG extraction from abdominal ECG using RLS based adaptive algorithms , 2017, 2017 18th International Carpathian Control Conference (ICCC).

[83]  Mamun Bin Ibne Reaz,et al.  Adaptive linear neural network filter for fetal ECG extraction , 2004, International Conference on Intelligent Sensing and Information Processing, 2004. Proceedings of.

[84]  F. Hamprecht Introduction to Statistics , 2022 .

[85]  Jan Nedoma,et al.  Influence of gestation age on the performance of adaptive systems for fetal ECG extraction , 2017 .

[86]  D. T. Kaplan,et al.  Fetal ECG extraction with nonlinear state-space projections , 1998, IEEE Transactions on Biomedical Engineering.

[87]  K. Faez,et al.  A new method for Foetal Electrocardiogram extraction using Adaptive Nero-Fuzzy Interference System trained with PSO algorithm , 2011, 2011 IEEE INTERNATIONAL CONFERENCE ON ELECTRO/INFORMATION TECHNOLOGY.

[88]  Pradeep Kumar,et al.  CAD for Detection of Fetal Electrocardiogram by using Wavelets and Neuro-Fuzzy Systems , 2016 .

[89]  Radek Martinek,et al.  Non-invasive Fetal ECG Extraction from Maternal Abdominal ECG Using LMS and RLS Adaptive Algorithms , 2016, AECIA.

[90]  M. Moien,et al.  1989 U.S. cesarean section rate steadies--VBAC rate rises to nearly one in five. , 1991, Birth.

[91]  Naif Alajlan,et al.  A wavelet optimization approach for ECG signal classification , 2012, Biomed. Signal Process. Control..

[92]  Carl Taswell,et al.  The what, how, and why of wavelet shrinkage denoising , 2000, Comput. Sci. Eng..

[93]  Michael B Bracken,et al.  Electronic fetal heart rate monitoring and its relationship to neonatal and infant mortality in the United States. , 2012, American journal of obstetrics and gynecology.

[94]  Radek Martinek,et al.  Refining the diagnostic quality of the abdominal fetal electrocardiogram using the techniques of artificial intelligence , 2012 .

[95]  Joachim Behar,et al.  A Comparison of Single Channel Fetal ECG Extraction Methods , 2014, Annals of Biomedical Engineering.

[96]  Jan Nedoma,et al.  Non-Invasive Fetal Monitoring: A Maternal Surface ECG Electrode Placement-Based Novel Approach for Optimization of Adaptive Filter Control Parameters Using the LMS and RLS Algorithms , 2017, Sensors.

[97]  D. Petitti,et al.  Cesarean section in California--1960 through 1975. , 1979, American journal of obstetrics and gynecology.

[98]  Hamid Hassanpour,et al.  Fetal ECG Extraction Using Wavelet Transform , 2006, 2006 International Conference on Computational Inteligence for Modelling Control and Automation and International Conference on Intelligent Agents Web Technologies and International Commerce (CIMCA'06).

[99]  G. Clifford,et al.  Clinically accurate fetal ECG parameters acquired from maternal abdominal sensors. , 2011, American journal of obstetrics and gynecology.

[100]  R. Swarnalath,et al.  Maternal ECG Cancellation in Abdominal Signal Using ANFIS and Wavelets , 2010 .

[101]  A K Mittra,et al.  Selection of mother wavelet and denoising algorithm for analysis of foetal phonocardiographic signals , 2009, Journal of medical engineering & technology.

[102]  Kazuo Tanaka,et al.  Fuzzy Control Systems Design and Analysis: A Linear Matrix Inequality Approach , 2008 .

[103]  Rabab Kreidieh Ward,et al.  Extraction of fetal ECG using adaptive Volterra filters , 2008, 2008 16th European Signal Processing Conference.

[104]  Ayten Atasoy,et al.  Performance evaluation of nonparametric ICA algorithm for fetal ECG extraction , 2011, Turkish Journal of Electrical Engineering and Computer Sciences.

[105]  M. J. Rooijakkers,et al.  A continuous wavelet transform-based method for time-frequency analysis of artefact-corrected heart rate variability data , 2011, Physiological measurement.

[106]  G. Clifford,et al.  A Review of Fetal ECG Signal Processing; Issues and Promising Directions. , 2010, The open pacing, electrophysiology & therapy journal.

[107]  Massimo Mischi,et al.  A robust fetal ECG detection method for abdominal recordings , 2007, Physiological measurement.

[108]  Christian Jutten,et al.  Multichannel Electrocardiogram Decomposition Using Periodic Component Analysis , 2008, IEEE Transactions on Biomedical Engineering.

[109]  Radek Martinek,et al.  The Use of LMS and RLS Adaptive Algorithms for an Adaptive Control Method of Active Power Filter , 2013 .

[110]  Ali Ghaffari,et al.  A new mathematical based QRS detector using continuous wavelet transform , 2008, Comput. Electr. Eng..

[111]  Marian Kotas,et al.  Combined Application of Independent Component Analysis and Projective Filtering to Fetal ECG Extraction , 2008 .

[112]  Gari D Clifford,et al.  Combining and benchmarking methods of foetal ECG extraction without maternal or scalp electrode data , 2014, Physiological measurement.

[113]  Marian F MacDorman,et al.  Fetal and Perinatal Mortality: United States, 2013. , 2015, National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System.

[114]  Jyh-Shing Roger Jang,et al.  ANFIS: adaptive-network-based fuzzy inference system , 1993, IEEE Trans. Syst. Man Cybern..

[115]  Babak Mohammadzadeh Asl,et al.  Fetal ECG extraction via Type-2 adaptive neuro-fuzzy inference systems , 2017, Comput. Methods Programs Biomed..

[116]  Sonia Charleston-Villalobos,et al.  Characterization of EHG contractions at term labor by nonlinear analysis , 2013, 2013 35th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC).

[117]  Wei Zheng,et al.  Single-lead fetal electrocardiogram estimation by means of combining R-peak detection, resampling and comb filter. , 2010, Medical engineering & physics.

[118]  Deniz Erdogmus,et al.  Independent components analysis for fetal electrocardiogram extraction: a case for the data efficient Mermaid algorithm , 2003, 2003 IEEE XIII Workshop on Neural Networks for Signal Processing (IEEE Cat. No.03TH8718).

[119]  Guangchen Liu,et al.  An adaptive integrated algorithm for noninvasive fetal ECG separation and noise reduction based on ICA-EEMD-WS , 2015, Medical & Biological Engineering & Computing.

[120]  Bernard Widrow,et al.  30 years of adaptive neural networks: perceptron, Madaline, and backpropagation , 1990, Proc. IEEE.

[121]  Jan Nedoma,et al.  Comparative Effectiveness of ICA and PCA in Extraction of Fetal ECG From Abdominal Signals: Toward Non-invasive Fetal Monitoring , 2018, Front. Physiol..

[122]  A. Gupta,et al.  A novel approach to fetal ECG extraction and enhancement using blind source separation (BSS-ICA) and adaptive fetal ECG enhancer (AFE) , 2007, 2007 6th International Conference on Information, Communications & Signal Processing.

[123]  Pan Du,et al.  Bioinformatics Original Paper Improved Peak Detection in Mass Spectrum by Incorporating Continuous Wavelet Transform-based Pattern Matching , 2022 .

[124]  Anil Kumar Tiwari,et al.  Design Methodology of a New Wavelet Basis Function for Fetal Phonocardiographic Signals , 2013, TheScientificWorldJournal.

[125]  P. Sutha,et al.  Fetal Electrocardiogram Extraction and Analysis Using Adaptive Noise Cancellation and Wavelet Transformation Techniques , 2017, Journal of Medical Systems.

[126]  F. Bereksi-Reguig,et al.  Wavelet denoising of the electrocardiogram signal based on the corrupted noise estimation , 2005, Computers in Cardiology, 2005.

[127]  Radek Martinek,et al.  Fetal ECG extraction based on adaptive neuro-fuzzy interference system , 2016, 2016 10th International Symposium on Communication Systems, Networks and Digital Signal Processing (CSNDSP).

[128]  Jan Nedoma,et al.  A Non-Invasive Multichannel Hybrid Fiber-Optic Sensor System for Vital Sign Monitoring , 2017, Sensors.

[129]  R Todd Constable,et al.  Maternal brain response to own baby-cry is affected by cesarean section delivery. , 2008, Journal of child psychology and psychiatry, and allied disciplines.

[130]  C Sureau Historical perspectives: forgotten past, unpredictable future. , 1996, Bailliere's clinical obstetrics and gynaecology.

[131]  Radek Martinek,et al.  Non-Adaptive Methods of Fetal ECG Signal Processing , 2017 .