Fetal Cardiac Timing Events Estimation From Doppler Ultrasound Signals Using Swarm Decomposition

Front Physiol. 2019 Jun 21:10:789. doi: 10.3389/fphys.2019.00789. eCollection 2019.

Abstract

Perinatal morbidity and mortality can be reduced when any cardiac abnormalities during a pregnancy are diagnosed early. Doppler Ultrasound Signals (DUS) are often used to monitor the heart rate of a fetus and they can also be used to identify the timing events of fetal cardiac valve motions. This paper proposed a novel, non-invasive technique which can be used to identify the fetal cardiac timing events based upon the analysis of fetal DUS (based upon 66 normal subjects belonging to three differing age groups) which can later be used to estimate fetal cardiac intervals from a DUS signal. The foundation of this method is a novel decomposition method referred to as Swarm Decomposition (SWD) which makes it possible for the frequency contents of Doppler signals to be associated with cardiac valve motions. These motions include the opening (o) and closing (c) of Aortic (A) and Mitral (M) valves. When compared the SWD method results to the Empirical Mode Decomposition for the validation, the fetal cardiac timings were estimated successfully when isolating the constituent parts of analyzed DUS signals with reduced complexity compared to EMD method. Pulsed Doppler images are used in order to verify the estimated timings. Three fetal age groups were assessed in terms of their cardiac intervals: 16-29, 30-35, and 36-41 weeks. The time intervals (Systolic Time Interval, STI), (Isovolumic Relaxation Time, IRT), and (Pre-ejection Period, PEP) were found to change significantly (p < 0.05) across the three age groups. The evaluation of fetal cardiac performance can be enhanced, given that these findings can be leveraged as sensitive markers throughout the process.

Keywords: doppler ultrasound; fetal assessment; fetal cardiac intervals; fetal heart rate; swarm decomposition.