Innovative Technologies and Signal Processing in Perinatal Medicine

✍ Scribed by Danilo Pani, Chiara Rabotti, Maria Gabriella Signorini, Laura Burattini

• Publisher: Springer
• Year: 2020
• Tongue: English
• Leaves: 236
• Edition: 1
• Category: Library

✦ Synopsis

Pregnancy is a critical time for the health of the mother and the fetus, with important potential risks for both. Tools for antenatal diagnosis and pregnancy monitoring can support prevention and management of potential risks and complications. In particular, the perinatal period, spanning from the third trimester of pregnancy up to one month after birth, is the most critical for the baby. For this reason, in the last decades, biomedical engineering supported and fostered the scientific research towards the identification of new models, parameters, algorithms, and tools that can improve the quality of fetal monitoring, predict the outcomes and allow physicians to intervene in an appropriate manner to ensure a healthy future for the baby. This book follows the First International Summer School on Technologies and Signal Processing in Perinatal Medicine and reflects some of its most important master lectures. It represents a valuable guide for students and young researchers approaching this topic for the first time, as well as experienced researchers and practitioners looking for a clear representation of the themes and techniques presented by recognized experts in the field.

Presents current and innovative technologies for fetal and neonatal monitoring
Emphasis on both technology/signal processing and clinical aspects
Offers a clear didactic approach to the subject matter

✦ Table of Contents

Preface
Contents
Chapter 1: Ultrasound in Pregnancy – From Ultrasound Physics to Morphological and Functional Measurements of the Fetus
1.1 Ultrasound Physics
1.1.1 Ultrasound Generation
1.1.2 Ultrasound Propagation
1.1.3 Ultrasound Echo
1.2 Ultrasound Imaging Technology
1.2.1 Ultrasound Beam Profile
1.2.2 Array Beam Forming
1.2.3 Ultrasound System
1.3 Ultrasound Doppler Technology
1.3.1 Doppler Principle
1.3.2 Receiver Architecture
1.3.3 Continuous and Pulsed Doppler
1.3.4 Velocity Estimators
1.3.5 Color and Power Doppler
1.4 Ultrasound in Pregnancy
1.4.1 First Trimester Scans
1.4.2 Second Trimester Scans
1.4.2.1 Fetal Biometry
1.4.2.2 Morphological Evaluation of the Fetal Heart
1.4.2.3 Functional Evaluation of the Fetal Heart
1.4.2.4 Liquor Volume
1.4.3 Third Trimester and Labor
1.4.3.1 Cardiotocography (CTG)
1.4.3.2 Umbilical Cord Doppler
1.4.3.3 Fetal Orientation
1.4.3.4 Cervical Length
References
Chapter 2: CRS4 Telemed: Open and Low-Cost Technologies for Real-Time Telesonography
2.1 Introduction
2.2 CRS4 Real-Time Telemedicine System
2.2.1 Evolution
2.2.2 Video Acquisition and Streaming
2.2.3 Architecture
2.2.3.1 Ultrasound Station
2.2.3.2 Specialist Station
2.2.3.3 Server
2.2.3.4 Workflow
2.2.3.5 Augmented Reality
2.3 Evaluating the System: Clinical and Economical Perspectives
2.3.1 Paediatric Cardiology
2.3.2 Point-of-Care Ultrasonography
2.3.3 Preliminary Cost-Benefit Analysis
2.4 Discussion
2.5 Conclusion
References
Chapter 3: Innovative Technologies for Intrauterine Monitoring of Predictive Markers of Vascular and Neurological Well-Being
3.1 Developmental Origins Hypothesis
3.2 Impact of CVD
3.3 Endotelial Dysfunction
3.4 Vascular Function Evaluation
3.5 Cardiac Function
3.6 Clinical Applications of Deformation Imaging in Pathological Pregnancies
3.6.1 Maternal Cardiac Study in Preeclampsia
3.6.2 Maternal Cardiac Study in Intrauterine Growth Restriction Disease
3.6.3 Fetal Cardiac Study in Intrauterine Growth Restriction Disease
3.7 Conclusions
References
Chapter 4: Cardiotocography for Fetal Monitoring: Technical and Methodological Aspects
4.1 Introduction
4.2 Computerized Cardiotocography
4.3 FHR Morphological Analysis
4.3.1 Baseline FHR and Baseline Measurements
4.3.2 Accelerations and Decelerations
4.4 Analysis of FHR Variability
4.4.1 Classical Time Domain Variability Indices
4.5 The Need for a Novel Approach
4.5.1 FHR Features in Frequency Domain
4.5.2 Nonlinear Domain Parameters
4.5.3 Phase-Rectified Signal Averaging
4.6 Application of Linear and NonLinear Analysis: Example of IUGR Detection
4.7 Conclusions
References
Chapter 5: Noninvasive Fetal Electrocardiography: Models, Technologies, and Algorithms
5.1 Introduction
5.2 Noninvasive Fetal Electrocardiography Data Model
5.2.1 Volume Conductor Model
5.2.2 Morphological Model
5.2.2.1 Template-Based Models
5.2.2.2 The Notion of Cardiac Phase
5.2.2.3 Dipolar Models
5.3 Digital Noninvasive Fetal ECG Acquisition
5.3.1 Acquisition Front-End Requirements
5.3.2 Analog-to-Digital Conversion Requirements
5.3.3 Sensor Placement
5.4 Single-Channel Fetal Electrocardiogram Extraction
5.4.1 Naive Fetal Electrocardiogram Detection and Extraction
5.4.2 Template Subtraction and Cyclostationary Random Process Theory
5.4.3 Adaptive Filters for fECG Extraction
5.4.4 Kalman Filters for fECG Extraction
5.5 Multichannel Fetal Electrocardiogram Extraction
5.5.1 Independent Component Analysis
5.5.2 Independent Subspace Analysis
5.5.3 Generalized Eigenvalue Decomposition
5.5.4 Periodic Component Analysis
5.5.5 Nonstationary Component Analysis
5.5.6 Approximate Joint Diagonalization Using ECG-Specific Priors
5.5.7 Illustration
5.6 Advanced Methods for Fetal ECG Extraction
5.6.1 Low-Rank Measurements and Nonlinearly Separable Fetal and Maternal ECG
5.6.2 Maternal-Fetal Subspace Decomposition by Deflation
5.6.3 Block-Wise and Online Fetal ECG Extraction
5.6.3.1 Block-Wise Analysis
5.6.3.2 Online Source Separation
5.7 Fetal ECG Post-processing
5.7.1 Fetal R-Peak Detection
5.7.2 Fetal ECG Enhancement
5.7.3 Fetal ECG Morphological Parameter Extraction
5.8 Conclusion
References
Chapter 6: Innovative Devices and Techniques for Multimodal Fetal Health Monitoring
6.1 Introduction
6.2 Current Fetal Health Monitoring Techniques
6.2.1 Devices in Clinical Fetal Health Monitoring
6.2.2 New Measurement Techniques in the Clinical Environment
6.2.2.1 Fetal Heart Rate Monitoring
6.2.2.2 Fetal Movement Monitoring
6.2.3 At-Home Fetal Monitoring Devices
6.3 Toward Clinically Relevant At-home Fetal Health Monitoring: Fetal Motion Detection
6.3.1 Selection of Measurement Modalities
6.3.2 Recording a Reference Data Set
6.3.3 Accelerometer-Based Fetal Motion Detection
6.3.3.1 Base Method
6.3.3.2 Detection Improvements
6.3.3.3 Discussion
6.3.4 Fetal ECG Based Fetal Motion Detection
6.3.4.1 Fetal QRS Extraction
6.3.4.2 Fetal Movement Detection
6.3.4.3 Discussion
6.4 Conclusion
References
Chapter 7: T-Wave Alternans Identification in Direct and Indirect Fetal Electrocardiography
7.1 What Is T-Wave Alternans?
7.2 Direct and Indirect Fetal Electrocardiography
7.3 T-Wave Alternans in Fetal Electrocardiography
7.3.1 Why Measuring T-Wave Alternans in Fetal Electrocardiography?
7.3.2 Improved Fetal Pan-Tompkins Algorithm for Automatic Detection of Fetal R Peaks
7.3.3 Segmented-Beat Modulation Method for Electrocardiographic Filtering
7.3.4 Heart-Rate Adaptive Match Filter Method
7.3.5 A Clinical Study
7.4 Final Remarks
References
Chapter 8: Advanced Signal Processing Algorithms for Cardiorespiratory Monitoring in the Neonatal Intensive Care Unit
8.1 Introduction
8.2 Clinical Background
8.2.1 The Neonatal Intensive Care Unit
8.2.2 Common Diagnoses and Pathologies in the NICU
8.3 Physiology of Cardiorespiratory Control in Infants
8.4 Methodology
8.4.1 Methods for Cardiorespiratory Control Assessment: Heart Rate Variability in Adults
8.4.2 Methods for Cardiorespiratory Control Assessment: Heart Rate Variability in Infants
8.5 Exemplary Methodology: A Statistical Approach
8.5.1 Basic Principles of Point Process Modeling
8.5.2 A Point Process Model of Cardiovascular Dynamics
8.5.3 A Point Process Model of Respiratory Dynamics
8.5.4 A Statistical Model of Cardio-Respiratory Dynamics
References
Chapter 9: Back to the Future: Prenatal Life and Perinatal Programming
9.1 Introduction
9.2 Perinatal Programming
9.3 Metabolomics
9.3.1 Prenatal Conditions
9.3.2 Perinatal Conditions
9.3.3 Post-Natal Period
9.3.4 Breastfeeding
9.3.5 Children
9.3.6 Adults
9.4 Microbiomics
9.5 Conclusions
References
Index