Fetal electrocardiogram (fECG) estimation is critical for assessing prenatal cardiovascular health; yet existing template-subtraction methods suffer from performance limitations and unnecessary complexity when hybridized with auxiliary techniques. Here, we present a novel, stand-alone template-subtraction system that significantly improves fECG signal extraction without the need for combinatorial approaches. Our method innovatively employs (a) ensemble averaging of low-pass-filtered maternal abdominal signals and their envelope for precise maternal R-peak localization, (b) dynamic R–R interval analysis to mitigate false positives/negatives in both maternal and fetal peak detection, and (c) fECG ensemble averaging to enhance fetal R-peak identification.
Validated on two public datasets, the system achieved near-perfect maternal R-peak detection and substantially improved fetal R-peak detection, matching the performance of complex hybrid systems while reducing computational burden. Additional analysis revealed a strong correlation between the estimated fECG and the direct fetal scalp electrocardiogram, with both detection accuracy and waveform fidelity positively associated with signal quality. Furthermore, the system demonstrated robust fetal heart rate (fHR) estimation on a third dataset. These results underscore the potential of optimized template subtraction as a clinically viable, low-complexity framework for non-invasive prenatal monitoring and fetal cardiac electrophysiology research.
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