DS04 - Vie, santé et bien-être

Computer assisted fetal monitoring – SurFAO

Submission summary

To monitor the well-being of a fetus or for a clinical diagnosis, a challenge is to extract a fetal electrocardiogram (fECG) signal of high quality from a limited number of non-invasive sensors on the maternal abdomen. The SurFAO project aims to enhance the current clinical routines for two actual clinical issues, each one facing different experimental and algorithmic challenges.
On the one hand, during childbirth, fetal monitoring is assessed by the fetal heart rate (FHR), classically from cardiotocography (CTG). The aim is to monitor FHR variability anomalies that reflect a too high fetal malaise. It is very common to have difficulties to reliably record FHR due to confusion of rhythms of the mother and the fetus that can lead to unnecessary caesareans. With 800000 childbirths in France per year, improving the reliability of FHR estimation by fECG analysis is therefore of high clinical interest. On the other hand, in earlier stages of pregnancy, more rarely, fetal cardiac rhythm disorders can be detected. Antiarrhythmic treatments are triggered via the mother and their effectiveness is evaluated by echographic monitoring. However, this does not allow monitoring over a long period. An access to fECG recordings to analyze the ECG waveforms morphology would allow more accurate diagnosis and a better tracking of treatment efficacy.
To deal with these clinical issues, the proposed approach aims at coupling two complementary cardiac information acquired at the best-located position. Therefore, the proposed solution is (i) to combine the use of electrophysiological sensors ECG and acoustic sensors of microphonic type that can register phonocardiographic signals (PCG), (ii) to assist by computer the clinical expertise to choose the best sensors location. Several methodological aspects will be considered: to improve the robustness of the FHR estimation with degraded signals based on multimodality, to overcome some practical limitations to extract the fECG waveforms by enhancing the process extraction with PCG and to assist the user in the sensors choice and placement by predicting their best locations and their kinds (ECG or PCG).
The SurFAO project proposes then an original approach of computer-assisted fetal monitoring and thus differs from previous published works of fECG extraction solutions, only based on algorithmic performances mostly in well-controlled situations. The original aspects of our proposal are the innovative methodological choices based on multimodality and informed recording process, the consideration of the medical uses and of the necessity to help the clinical monitoring to design the algorithms, the new reference multimodal database, and the academic-clinical consortium, that will guarantee the relevance of all proposed parts.
To achieve the proposed objectives, the project gathers clinical and academic partners together in a strong consortium. First, clinical uses and medical devices specifications will be defined for both considered applications; this will end to the submission to ethical committees of 2 clinical trials. Accordingly, after their acceptations, data collections will be carried out with the expertise of the clinical partner and structured in an original multimodal database. In parallel, the academic partners will work on the methodological developments to propose new algorithms of FHR estimation and fECG extraction, based on ECG-PCG multimodality, as well as innovative methods to assist the user by indicating the sensor locations and kinds. Finally, the proposed methods will be validated on the new acquired clinical data, based on clinical parameters analysis and interpretation.
SurFAO project aims, over time, at developing a medical device to assist the medical act of fetal cardiac monitoring reliable even in degraded or pathological conditions. We intend to provide some experimental and algorithmic solutions to help clinicians in their daily work and to improve the fetal cardiac monitoring.

Project coordination

Julie Fontecave-Jallon (TIMC-IMAG)

The author of this summary is the project coordinator, who is responsible for the content of this summary. The ANR declines any responsibility as for its contents.


GIPSA-Lab Grenoble Image, Parole, Signal, Automatique
CHUGA/CIC-IT Centre Hospitalo-Universitaire Grenoble Alpes

Help of the ANR 456,907 euros
Beginning and duration of the scientific project: - 48 Months

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