Fetal ECG signal processing and identification of hypoxic pregnancy conditions in-utero

The fetal heart rate (fHR) variability and fetal electrocardiogram (fECG) are considered the most important sources of information about fetal wellbeing. Non-invasive fetal monitoring and analysis of fECG are paramount for clinical trials. They enable examining the fetal health status and detecting the heart rate changes associated with insufficient oxygenation to cut the likelihood of hypoxic fetal injury. Despite the fact that significant advances have been achieved in electrocardiography and adult ECG signal processing, the analysis of fECG is still in its infancy. Due to accurate fetal morphology extraction techniques have not been properly developed, many areas require particular attention on the way of fully understanding the changes in variability in the fetus and implementation of the non-invasive techniques suitable for remote home care which is increasingly in demand for high-risk pregnancy monitoring. In this paper, we introduce an integrated approach for fECG signal extraction and processing based on various methods for fetal welfare investigation and hypoxia risk estimation. To the best of our knowledge, this is the first attempt to introduce the auto-generated risk scoring in fECG to achieve early warning on fetus' safety and provide the physician with additional information about the possible fetal complications. The proposed method includes the following stages: fECG extraction, fHR and fetal heart rate variability (fHRV) calculation, hypoxia index (HI) evaluation and risk estimation. The extracted signals were examined by assessing Signal to Noise Ratio (SNR) and mean square error (MSE) values. The results obtained demonstrated great potential, but more profound research and validation, as well as a consistent clinical study, are needed before implementation into the hospital and at-home monitoring.