Cardiotocography

Since 1960's obstetricians have been using cardiotocography (CTG) to detect ongoing hypoxia of the fetus. CTG consists of fetal heart rate (fHR) and uterine contractions (TOCO) signals. The evaluation of the fHR in clinical settings is ruled by FIGO guidelines based on evaluation of macroscopic morphological features derived from the fHR, such as baseline variability and its relation to the TOCO.

Although upgrades to the guidelines were proposed - none of them is taking into account results achieved within the adult heart rate variability (HRV) research.

Our work focuses on evaluation of almost complete set of features, that were previously used for fHR description. Features are assessed based on their inter-correlation, information gain or statistical significance in the task of distinguishing the records into three FIGO classes and/or based on pH value.

We assess the features on a large (and still growing) data set with two types of the evaluation:

  • Expert (subjective) evaluation - acquired from the cooperating experienced obstetricians.
  • Objective values of pH from the umbilical artery

Obrázek popisujici metodologii CTG evaluace

Since 2010 we are involved in two projects concerning the CTG evaluation.

Mobile Cardiotocography within the MAS project
We are responsible for software developement in several parts of the project:
  • Automatic detection of the best site for phonocardiography microphone placement on the abdomen.
  • Developement of the Android application for the "mobile" processing of the CTG signal. Transfer of the signal is also big part of this task.
  • Developement of the clinical application for the obstetrician. The application should serve as light decission support system for the clinicans. It should also allow respons of the clinician to the patient at home.
Cardiotocography evaluation by means of artificial inteligence
The main goal of this project is to research the possible ways of bringing automatic preprocessing to the CTG evaluation for possible future full-fledged obstetrician's decission support system. The subgoals of the project are:
  • Collection of the database with proper size and proper structure
  • Developement of preprocessing tools for CTG signal preprocessing
  • Developement of new GUI for semi-automatic CTG evaluation
  • Expert-system like approach to the CTG evaluation using clinical data from the HIS.



Contact persons: Václav Chudáček, Jiří Spilka

Cooperating institutions
  • Department of Obstetrics & Gyneacology, FN Brno, Czech republic
  • Department of Obstetrics & Gyneacology, VFN Prague, Czech republic

Funding
This project is partly supported by the research projects #MSM 6840770012 "Transdisciplinary Biomedical Engineering Research II from Ministry of Education, Youth and Sports of the Czech Republic" and by the projects (number is needed).

Our publications
  1. Chudáček, V. - Huptych, M. - Koucký, M. - Bauer, L. - Spilka, J. - et al. Fetal Heart Rate Data Pre-Processing and Annotation In: Proceedings of 9th Intrenational Conference on Information Technology and Applications in Biomedicine [CD-ROM]. Piscataway: IEEE, 2009, ISBN 978-1-4244-5379-5.