Perinatology
In the domain of perinatology, BM/d research aims at three different, but strongly linked, stages: pregnancy, labour, and the neonatal stage.
During pregnancy and labour, some of the most important risks to the unborn child (i.e. fetus) are preterm delivery, intra-uterine growth restriction, congenital anomalies, and (labour-induced) hypoxia. Our research aims to develop methods for improved assessment of the fetal health condition to enable timely intervention when these complications occur. Critical parameters for pregnancy and labour monitoring are the cardiac activity of the fetus and the contractility of the myometrium (i.e. the uterine muscle). Unfortunately, due to the important limitations posed by鈥痗urrent pregnancy monitoring techniques, reliable assessment of the health condition of mother and fetus is often impossible, resulting in ineffective or late interventions.
Electrophysiological pregnancy monitoring by electrodes placed on the abdomen of a pregnant woman has been shown, also thanks to the contribution of the BM/d lab, to be a promising alternative to current approaches. Our focus is on the analysis of signals such as the fetal electrocardiogram (ECG) and the electrohysterogram (EHG), which are indicators of the fetal cardiac activity and uterine contractility, respectively. These signals can be obtained non-invasively and can not only provide the information that is currently used in pregnancy healthcare (i.e. cardiotocogram), but can also provide further information via ECG waveform analysis for assessment of congenital heart disease or oxygenation and via EHG analysis for predicting the risk of preterm delivery or assessing the progress of labour and the risk of postpartum haemorrhage.
The non-invasive electrophysiological measurements that we perform within the BM/d lab, also enable us to study the cardiovascular interaction between mother and fetus (i.e., fetomaternal coupling), as mediated by the placenta and uterus, to obtain a more fundamental understanding of how these systems hemodynamically interact with each other.
Next to electrophysiological pregnancy monitoring, ultrasound technology is also being developed to perform continuous Doppler assessment of the fetal heart rate leveraging automatic fetal-heart tracking. This allows optimizing the investigation of fetal cardiac rhythm without need for operator intervention, but exploiting a small flexible transducer placed on the maternal abdomen. This is also being used for ultrasound strain imaging aimed at the analysis of uterine contractions. Finally, contrast enhanced ultrasound technology is being optimized for assessment of placental perfusion and for characterization of the placental microvascular architecture by advanced ultrasound localization microscopy approaches.
In the neonatal stage, premature infants born too early are often admitted to a neonatal intensive care unit (NICU). These vulnerable babies are cardiorespiratory unstable and at risk of encountering critical or undesired conditions such as central apnea, sepsis, and sleep disturbances, necessitating extensive care and medical intervention, with severe consequences for the long-term outcome. By analyzing vital signals like ECG, heart rate, respiration, and oxygen saturation obtained from patient monitors, we focus on the development of intelligent algorithms to predict these conditions. This approach enables earlier and more targeted interventions, enhances alarm management, and ultimately leads to better clinical outcomes, improved staff experiences, and reduced costs.
Beyond traditional sensors, the integration of non-invasive or contactless sensors, such as video cameras and optical fiber mats, is particularly vital for this fragile population. Their delicate skin often cannot tolerate the attachment of conventional sensors or electrodes. Monitoring and predictive modeling using these innovative sensors are at the forefront of research in this field.
Additionally, the ability to predict treatment responses and effects in neonates represents another critical area of study. Such advancements would empower clinicians to personalize care and make more informed decisions, significantly improving outcomes for this sensitive patient group.
Our research includes validation of new sensing technologies, development of accurate mathematical models describing the underlying physiology, development of data-driven models, and design of dedicated signal processing tools. The ultimate challenge is permitting accurate and non-invasive extraction, analysis, and classification of parameters which are necessary for reliably monitoring of mother and child around pregnancy and childbirth.
Research is carried out in tight collaboration with clinical partners such as the M谩xima Medical Center in Veldhoven and the Amsterdam UMC.