A rule-based phonocardiographic method for long-term fetal heart rate monitoring

A real-time method for fetal heart rate (FHR) monitoring based on signal processing of the fetal heart sounds is presented. The acoustic method, which utilizes an adaptive time pattern analysis to select and analyze those heartbeats that can be recorded without artefact, is guided by a number of rules involving an introduced confidence factor on the timing prediction. The algorithm was implemented in a low-power portable electronic instrument to enable long-term fetal surveillance. A large number of clinical tests have shown the very good performance of the phonocardiographic method in comparison with FHR curves simultaneously recorded with ultrasound cardiotocography. Indeed, approximately 90% of the time, the acoustic FHR curve remained inside a ±3 beats/min tolerance limit of the reference ultrasound method. The confidence was typically CF>0.85. The acoustic method exceeded a ±5 beats/min limit relative to the ultrasound method approximately 5% of the time. Finally, no relevant FHR data was measured approximately 5% of the time.