Fetal heart rate monitoring is a crucial aspect of prenatal care that has limitations with traditional methods. Recent advancements in wearable sensors and AI algorithms have introduced new approaches that address some of these limitations, including accuracy, comfort, and mobility. However, the use of these technologies raises ethical concerns related to privacy, informed consent, accuracy, and reliability of AI algorithms, potential for misdiagnosis or overdiagnosis, and equity in access to technology and healthcare. While recent studies demonstrate the potential benefits of wearable sensors and AI algorithms for fetal heart rate monitoring, they also highlight the need for continued dialogue and collaboration between healthcare providers, technology developers, and policymakers to ensure the ethical use of these technologies. This chapter will examine the ethical considerations related to the use of wearable sensors and AI algorithms in fetal heart rate monitoring, emphasizing the need for responsible and ethical use of these technologies.
Top1. Brief Overview Of The Use Of Wearable Sensors And Ai Algorithms In Fetal Heart Rate Monitoring
Wearable sensors for fetal heart rate monitoring typically involve the use of a small, wireless device that is attached to the mother's abdomen. The device records electrical signals from the fetal heart and transmits them to a monitoring system. This allows for continuous monitoring of fetal heart rate without the need for invasive procedures, such as scalp electrodes.
AI algorithms can be used to analyze the collected data and identify potential abnormalities or irregularities in fetal heart rate patterns. These algorithms can be trained on large datasets of fetal heart rate data and can learn to identify patterns that may indicate fetal distress or other issues. This can help healthcare providers make more accurate diagnoses and decisions related to the management of pregnancy.
Several studies have demonstrated the potential benefits of wearable sensors and AI algorithms for fetal heart rate monitoring. For example, a study conducted in 2018 by Reuwer and colleagues found that the use of wearable ECG sensors for fetal heart rate monitoring as shown in figure 1 was associated with a reduction in the number of EFM recordings required and an increase in patient satisfaction compared to traditional EFM methods (Reuwer et al., 2018).
Figure 1. Illustration of the fetal ECG monitoring system
Another study conducted in 2019 by Reddy and colleagues found that an AI algorithm developed for fetal heart rate analysis as shown in figure 2 and 3 was able to accurately predict neonatal acidemia (a condition that can occur when the fetus is not receiving enough oxygen) with a sensitivity of 92.5% and a specificity of 87.2% (Reddy et al., 2019).
Figure 2. (a) Front and (b) back sides of the fetal ECG collector circuit board
Figure 3. Fetal ECG collector: (a) Front view; (b) back view
While these studies demonstrate the potential benefits of wearable sensors and AI algorithms for fetal heart rate monitoring, they also highlight the ethical considerations that must be addressed to ensure the responsible and ethical use of these technologies.
1.1 Importance of Fetal Heart Rate Monitoring During Pregnancy
Fetal heart rate monitoring is a vital aspect of prenatal care as it provides important information about the health and wellbeing of the developing fetus. Monitoring fetal heart rate during pregnancy can help healthcare providers identify potential issues early on and take appropriate measures to manage the pregnancy and ensure the best possible outcome for the mother and the baby. In this section, we will discuss the importance of fetal heart rate monitoring during pregnancy.
1.2 Identification of Fetal Distress
Fetal distress is a condition where the fetus is not receiving enough oxygen or nutrients as shown in figure 4, and its health is compromised. Fetal distress can be caused by a variety of factors, including problems with the placenta, umbilical cord, or the mother's health. Fetal heart rate monitoring can help identify fetal distress early on, allowing healthcare providers to take appropriate measures to manage the pregnancy and prevent further complications.
Figure 4. Fetal distress due to lack of oxygen
For example, if a healthcare provider observes a sudden and sustained decrease in fetal heart rate, they may suspect fetal distress and take steps to improve fetal oxygenation and prevent further deterioration of the fetal condition. In severe cases of fetal distress, the delivery may be necessary to prevent serious health consequences for the fetus.