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Fetal electrocardiogram (fECG) assessment is essential throughout pregnancy to monitor the wellbeing and development of the fetus, and to possibly diagnose potential congenital heart defects. Due to the high noise incorporated in the abdominal ECG (aECG) signals, the extraction of fECG has been challenging. And it is even a lot more difficult for fECG extraction if only one channel of aECG is provided, i.e., in a compact patch device. In this paper, we propose a novel algorithm based on the Ensemble Kalman filter (EnKF) for non-invasive fECG extraction from a single-channel aECG signal. To assess the performance of the proposed algorithm, we used our own clinical data, obtained from a pilot study with 10 subjects each of 20 min recording, and data from the PhysioNet 2013 Challenge bank with labeled QRS complex annotations. The proposed methodology shows the average positive predictive value (PPV) of 97.59%, sensitivity (SE) of 96.91%, and F1-score of 97.25% from the PhysioNet 2013 Challenge bank. Our results also indicate that the proposed algorithm is reliable and effective, and it outperforms the recently proposed extended Kalman filter (EKF) based algorithm. 

The invasive method of fetal electrocardiogram (fECG) monitoring is widely used with electrodes directly attached to the fetal scalp. There are potential risks such as infection and, thus, it is usually carried out during labor in rare cases. Recent advances in electronics and technologies have enabled fECG monitoring from the early stages of pregnancy through fECG extraction from the combined fetal/maternal ECG (f/mECG) signal recorded non-invasively in the abdominal area of the mother. However, cumbersome algorithms that require the reference maternal ECG as well as heavy feature crafting makes out-of-clinics fECG monitoring in daily life not yet feasible. To address these challenges, we proposed a pure end-to-end deep learning model to detect fetal QRS complexes (i.e., the main spikes observed on a fetal ECG waveform). Additionally, the model has the residual network (ResNet) architecture that adopts the novel 1-D octave convolution (OctConv) for learning multiple temporal frequency features, which in turn reduce memory and computational cost. Importantly, the model is capable of highlighting the contribution of regions that are more prominent for the detection. To evaluate our approach, data from the PhysioNet 2013 Challenge with labeled QRS complex annotations were used in the original form, and the data were then modified with Gaussian and motion noise, mimicking real-world scenarios. The model can achieve a F1 score of 91.1% while being able to save more than 50% computing cost with less than 2% performance degradation, demonstrating the effectiveness of our method. 

Monitoring of fetal electrocardiogram (fECG) would provide useful information about fetal wellbeing as well as any abnormal development during pregnancy. Recent advances in flexible electronics and wearable technologies have enabled compact devices to acquire personal physiological signals in the home setting, including those of expectant mothers. However, the high noise level in the daily life renders long-entrenched challenges to extract fECG from the combined fetal/maternal ECG signal recorded in the abdominal area of the mother. Thus, an efficient fECG extraction scheme is a dire need. In this work, we intensively explored various extraction algorithms, including template subtraction (TS), independent component analysis (ICA), and extended Kalman filter (EKF) using the data from the PhysioNet 2013 Challenge. Furthermore, the modified data with Gaussian and motion noise added, mimicking a practical scenario, were utilized to examine the performance of algorithms. Finally, we combined different algorithms together, yielding promising results, with the best performance in the F1 score of 92.61% achieved by an algorithm combining ICA and TS. With the data modified by adding different types of noise, the combination of ICA–TS–ICA showed the highest F1 score of 85.4%. It should be noted that these combined approaches required higher computational complexity, including execution time and allocated memory compared with other methods. Owing to comprehensive examination through various evaluation metrics in different extraction algorithms, this study provides insights into the implementation and operation of state-of-the-art fetal and maternal monitoring systems in the era of mobile health.