Prospective Clinical Testing of a "Beat-To-Beat" Extraction Method for Fetal Electrocardiography.

IF 1.6 3区医学 Q3 OBSTETRICS & GYNECOLOGY

Fetal Diagnosis and Therapy Pub Date : 2026-04-02 DOI:10.1159/000550821

Anita Krishnan, Pooneh Roshanitabrizi, Anqing Zhang, Emily Boland, Jordyn Britton, Trong Nguyen, Van Khanh Lam, Stephanie Lacey, Raj Shekhar, Homa K Ahmadzia, Ahmet A Baschat, Mary T Donofrio, Rathinaswamy Govindan

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引用次数: 0

Abstract

Introduction: There is a critical clinical need for fetal electrocardiography (fECG), but no methods have successfully translated to the ambulatory setting. We developed a novel fECG system combining custom hardware and null coherence-based signal processing, then evaluated its feasibility for fECG extraction in normal and at-risk pregnancies.

Methods: We applied the fECG system to 43 patients (25 normal fetuses, 18 abnormal). FECG studies were 15 min long and utilized 12-24 electrodes and 1 ground. Signal processing was done during collection with additional post-processing. Two clinician raters blinded to gestational age, indication, and each other's assessments, graded the quality of studies using a 5-point scale. The raters measured the PR, QRS, and/or QTc intervals twice where possible.

Results: In 43 subjects, 30 had time-resolved fECG separation (70%) and the median grading (based on two raters across two sessions) was 3 or greater in 26/43 fetuses (60%) with graded studies. Sixty three percent of cases (27/43) had a measurable fetal cardiac time interval. Signal quality was reduced in participants with BMI ≥30 and during the vernix period (25-32 weeks' gestation).

Conclusion: Our findings demonstrate the feasibility of fECG across gestation, enabling beat-to-beat signal extraction and CTI measurement with a 63% success rate.

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胎儿心电图“心跳对心跳”提取方法的前瞻性临床试验。

胎儿心电图（fECG）是一个关键的临床需要，但没有方法成功地转化为门诊设置。我们开发了一种新的fECG系统，结合了定制硬件和基于零相干的信号处理，然后评估了其在正常和高危妊娠中提取fECG的可行性。方法：对43例胎儿（正常胎儿25例，异常胎儿18例）应用fECG系统。FECG研究时间为15分钟，使用12-24个电极和1个接地。在采集过程中进行信号处理，并进行额外的后处理。两名不考虑胎龄、适应症和彼此评估的临床医生评分者采用5分制对研究质量进行评分。评分者在可能的情况下测量PR、QRS和/或QTc间隔两次。结果：在43例受试者中，30例有时间分辨的fECG分离（70%），在分级研究中，26/43例胎儿（60%）的中位评分（基于两个评分者在两个疗程中的评分）为3或更高。63%的病例（27/43）有可测量的胎儿心脏时间间隔（fCTI）。BMI≥30的参与者和妊娠期（25-32周）的信号质量下降。结论：我们的研究结果证明了fECG在整个妊娠期的可行性，使心跳信号提取和CTI测量成功率达到63%。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Fetal Diagnosis and Therapy 医学-妇产科学

CiteScore

4.70

自引率

9.10%

发文量

审稿时长

6-12 weeks

期刊介绍： The first journal to focus on the fetus as a patient, ''Fetal Diagnosis and Therapy'' provides a wide range of biomedical specialists with a single source of reports encompassing the common discipline of fetal medicine.