SCH: INT: Transabdominal Fetal Oximetry for Improved Intrapartum Fetal Monitoring

该项目将改善分娩和分娩期间胎儿健康监测的现状，这是一个几乎涉及每个家庭的保健问题。自从大约半个世纪前将电子胎儿监护（EFM）引入产房以来，全国剖宫产率上升了五倍。剖宫产术的主要需求是担心胎儿大脑缺氧或缺氧脑损伤。这些损伤会导致脑瘫等问题。虽然剖宫产手术的数量有所增加，但与缺氧有关的各种健康状况的发生率保持不变。EFM的根本问题是，除了缺氧，一些无害的因素也会引起惊人的EFM痕迹，这可能导致不必要的医疗干预。该项目旨在通过研究、开发和验证无创经腹测量胎儿动脉血氧饱和度的技术来解决这一问题。此外，该项目还包括具体的教育和外展活动，这些活动由将研究成果融入课程、招募和留住来自代表性不足背景的学生进入STEM教育推动。本建议通过发展胎儿血氧饱和度的无创测量来解决这些问题。该项目开发了一套全面的组织模型，考虑了患者之间的差异和产时动态，以便研究分娩和分娩过程中腹部区域光传播的基本原理。该项目包括将几个精心挑选的波长的近红外光照射到母体腹部，然后对漫反射光进行跨腹部感应，并将非常微弱的胎儿光体积脉搏仪与母体和其他产生感应信号的噪音隔离开来。本文将研究几种提高系统鲁棒性的方法，如自适应噪声消除、用于动态校准的时间分辨光谱以及通过传感器阵列进行的相关测量。将开展一项涉及缺氧妊娠羊模型和人类受试者的广泛评估计划。该奖项反映了美国国家科学基金会的法定使命，并通过使用基金会的知识价值和更广泛的影响审查标准进行评估，被认为值得支持。

This project will improve the current state of fetal health monitoring during labor and delivery, an healthcare issue that touches almost every family. Since introduction of electronic fetal monitoring (EFM) to the labor and delivery rooms about half a century ago, the national rate of Cesarean section deliveries has risen five-fold. The main need driving Cesarean sections is a concern for oxygen deprivation in the fetsus' brain or hypoxic brain injury. These injuries result in problems such as cerebral palsy. While the number of Cesarean sections has increased, the rates of various health conditions associated hypoxia remain unchanged. The fundamental problem with EFM is that besides hypoxia, a number of innocuous factors can cause alarming EFM traces, which may lead to unnecessary medical interventions. The project aims to address this problem by research, development and validation of technology for non-invasive transabdominal measurement of fetal arterial blood oxygen saturation. Furthermore, the project includes specific education and outreach activities that are driven by integration of research results into courses, and recruitment and retention of students from underrepresented backgrounds into STEM education.This proposal to address these issues through development of non-invasive measurement of fetal blood oxygen saturation. The project develops a comprehensive set of tissue models that consider inter-patient variation and intrapartum dynamics, to allow investigation of the fundamentals of light propagation in the abdominal area in the context of labor and delivery. The project involves shining near infrared light at several carefully selected wavelengths into the maternal abdomen, followed by transabdominal sensing of diffuse reflectance light, and isolation of very weak fetal photo-plethysmographs from the maternal and other noises contributing to the sensed signal. Several approaches to improve system robustness in face of intrapartum dynamics, such as adaptive noise canceling, time-resolved spectroscopy for dynamic calibration, and correlated measurements via a sensor array will be investigated. An extensive evaluation plan involving hypoxic pregnant sheep models and human subjects will be carried out.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.