Special Session on Computational Fetal Monitoring

Abstract

Despite the improvements made in perinatal medicine during the 20th century, stillbirths still occur for 1 in 160 pregnancies in the US which represents a total of 26,000 fetal deaths each year. In addition, approximately 1 in 1000 fetuses experience oxygen deprivation during labor which is severe enough to cause brain injury. It is estimated that half of these cases of birth-related injury are preventable. Incorrect cardiotocography (CTG) interpretation is leading the list of causes.Intrapartum CTG is used routinely to measure maternal uterine pressure and fetal heart rate (FHR). Antepartum CTG monitoring is used to identify fetuses at risk of intrauterine hypoxia and acidaemia. As early as 28 weeks of gestation, analysis of the FHR trace is used as a nonstress test to assess the fetal well-being. In the perinatal period, timely, appropriate intervention can avoid fetal neurological damage or death. The CTG is visually assessed by a clinician or interpreted by computer analysis. In the context of labor monitoring, the CTG is used for continuous fetal monitoring. An abnormal heart rate will lead the clinician to perform a cesarean.With the recent advances in machine learning and statistical signal analysis new algorithms for assessing fetal antepartum or intrapartum health status are being elaborated. These algorithms process signals recorded by CTG monitors or alternative monitoring techniques such as scalp electrocardiography or non-invasive fetal electrocardiography. This session discusses the history of fetal monitoring, its current challenges and the prospects opened by recent algorithmic development.