Apparatus and method for non-invasive, passive fetal heart monitoring

• US 7,869,863 B2
• Filed: 01/10/2008
• Issued: 01/11/2011
• Est. Priority Date: 01/10/2008
• Status: Active Grant

• Current Assignee: Johns Hopkins University
• Original Assignee: Johns Hopkins University
• Inventors: Sternberger, Wayne I., Magnani, Timothy P., Cristion, John A., Daniels, Susanne M., Moses, Edward J.
• Primary Examiner(s): Layno; Carl H
• Assistant Examiner(s): Gedeon; Brian T
• Application Number:
  US11/971,940
• Publication Number:
  US 20090182242A1
• Time in Patent Office: 1,097 Days
• Field of Search: 600/511, 600/338, 600/376, 600/521
• US Class Current: 600/511
• CPC Class Codes: A61B 5/02411 of foetuses
• CPC Class Codes: A61B 5/344 Foetal cardiography
• CPC Class Codes: A61B 5/4362 Assessing foetal parameters

Abstract

The present invention provides a method and apparatus for monitoring the fetal condition in an objective, quantitative, and non-invasive manner by enabling continuous and highly specific data collection during pre-natal development and the intra-partum period. In an embodiment, monitoring the fetal condition comprises monitoring a fetal heart rate, a fetal heart rate variability, and/or the fetal heart vector orientation of a fetus in a pregnant mother. Automated signal processing techniques are applied to a multiplicity of transducers to select an optimum signal vector to monitor at least one of a fetal heart rate, a fetal heart rate variability, and/or the fetal heart vector orientation of a fetus in a pregnant mother.

Claims

1. An automated method of monitoring the fetal electrocardiographic waveform of a fetus in a pregnant mother to extract a high quality fetal signal from an abundance of signal channels, said method comprising:

a) measuring, in real-time, biopotential waveforms indicative of either one of a maternal heart or a maternal heart beat and a fetal heart beat;

b) isolating a single biopotential waveform from among said measured biopotential waveforms for use as a reference fetal waveform;

c) enhancing the isolated reference fetal waveform to remove correlated noise;

d) monitoring the enhanced isolated reference fetal waveform in real-time via at least one fetal monitoring algorithm;

e) monitoring an output quality metric via at least one quality metric monitoring algorithm to determine if it is within an acceptable range; and

f) dynamically adjusting at least one processing parameter of the at least one fetal monitoring algorithm to maintain the output quality metric within said acceptable range.

2. A method according to claim 1, wherein said measuring step further comprises:

acquiring said biopotential waveforms from at least one sensor located external to the mother;

forming a plurality of differential electrocardiogram (ECG) bipolar vectors from the acquired biopotential waveforms.

3. A method according to claim 1, wherein said plurality of biopotential waveform signals are acquired as unipolar signals.

4. A method according to claim 1, wherein said isolating step further comprises:

extracting a high quality fetal signal from an abundance of abdominal channels for use as said reference fetal waveform.

5. A method according to claim 1, wherein said enhancing step further comprises:

linearly combining said measured biopotential waveforms to maximize the reference fetal waveform and reduce uncorrelated noise.

6. A method according to claim 1, wherein said monitoring step (d) further comprises:

monitoring the enhanced reference fetal waveform over a short term re-evaluation interval on the order of substantially 10 to 30 seconds to determine whether the fetal heart rate is present and is within physiologically acceptable bounds.

7. A method according to claim 1, wherein said step (e) of monitoring said output quality metric further comprises:

monitoring the enhanced reference fetal waveform over a long term re-evaluation interval on the order of substantially 1 to 2 minutes to determine whether a fetal heart vector has moved within a monitoring montage array.

8. A method according to claim 1, wherein said monitoring of said output quality metric further comprises:

utilizing a quality score associated with the quality of the fetal waveform, based on one or more metrics, and

dynamically adjusting appropriate parameters when said quality score falls below a predetermined threshold to ensure that the quality of the fetal waveform is optimized.

9. A method according to claim 4, wherein said quality metric is selected from the group consisting of:

(a) outliers from the mean, (b) fraction of outliers from the median, (c) waveform variability, (d) normalized median deviation of RR intervals, (e) signal to noise ratio and (f) normalized standard deviation of RR intervals.

10. A method according to claim 1, wherein said step of dynamically adjusting said one or more processing parameters further comprises:

dynamically adjusting said one or more processing parameters associated with said at least one fetal monitoring algorithm, to adjust its sensitivity, accuracy and rapidity of convergence to estimates of interest.

11. A method according to claim 1, wherein said one or more processing parameters are based on certain input data characteristics of said measured biopotential waveforms and a pre-defined set of rules.

12. A method according to claim 1, wherein said one or more processing parameters are selected from the group consisting of (a) processing window length, (b) window overlap, (c) filter cutoffs, (d) input channel weights, (e) LMS learning coefficient, (f) Weiner filter length.

13. A method according to claim 1, wherein said step of dynamically adjusting one or more processing parameters further comprises the step of:

continuously minimizing quality scores.

14. A system for monitoring the fetal electrocardiographic waveform of a fetus in a pregnant mother to extract a high quality fetal signal from an abundance of abdominal channels, said system comprising:

a) means for measuring, in real-time, biopotential waveforms indicative of either one of a maternal heart or a maternal heart beat and a fetal heart beat;

b) means for isolating a single biopotential waveform from among said measured biopotential waveforms for use as a reference fetal waveform;

c) means for enhancing the isolated reference fetal waveform to remove correlated noise;

e) means for monitoring the enhanced isolated reference fetal waveform in real-time via at least one fetal monitoring algorithm;

f) means for monitoring an output quality metric via at least one quality metric monitoring algorithm to determine if it is within an acceptable range; and

g) means for dynamically adjusting at least one processing parameter of the at least one fetal monitoring algorithm to maintain the output quality metric within said acceptable range.

15. A system according to claim 14, wherein said means for measuring further comprises:

means for acquiring said biopotential waveforms from at least one sensor located external to the mother; and

means for forming a plurality of differential electrocardiogram (ECG) bipolar vectors from the acquired biopotential waveforms.

16. A system according to claim 14, wherein said plurality of biopotential waveform signals are acquired as unipolar signals.

17. A system according to claim 14, wherein said means for enhancing comprises:

linearly combining said measured biopotential waveforms to maximize the reference fetal waveform and reduce uncorrelated noise.

18. A system according to claim 14, wherein said monitoring step comprises:

monitoring the enhanced reference fetal waveform over a short term re-evaluation interval on the order of substantially 10 to 30 seconds to determine whether the fetal heart rate is present and is within physiologically acceptable bounds.

19. A system to claim 14, wherein said means for dynamically adjusting said one or more processing parameters further comprises:

dynamically adjusting said one or more processing parameters associated with said at least one fetal monitoring algorithm, to adjust its sensitivity, accuracy and rapidity of convergence to estimates of interest.

20. A system according to claim 14, wherein said one or more processing parameters are based on certain input data characteristics of said measured biopotential waveforms and a pre-defined set of rules.

21. A system according to claim 14, wherein said one or more processing parameters are selected from the group consisting of:

(a) processing window length, (b) window overlap, (c) filter cutoffs, (d) input channel weights, (e) LMS learning coefficient, (f) Weiner filter length.

22. A system according to claim 14, wherein said means for dynamically adjusting one or more processing parameters further comprises means for continuously minimizing quality scores.