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The umbilical cord suspends the fetus within the amniotic cavity, where fetal dynamics is one of its many functions. Hence, the umbilical cord is a viable index in determining fetal activity. Fetal movements result in mechanical loads that are fundamental for fetal growth. At present, mechanical environment during early human fetal development is still largely unknown. To determine early fetal movement dynamics at given physiological (0.060 m) and pathological umbilical cord lengths (0.030 m, 0.020 m, 0.017 m and 0.014 m) a 2D computational model was created to simulate dynamic movement conditions. Main findings of this computational model revealed the shortest umbilical cord length (0.014 m) with a

Background Cesarean scar pregnancy is a complicated and potentially life-threatening type of ectopic pregnancy. This study reports two women with cesarean scar pregnancy who were successfully treated with systemic methotrexate administration, and two other women who needed local re-administration of methotrexate after systemic injection. Case presentation Four Iranian pregnant women aged 29–34 years who were between 5 to 7 gestational weeks with cesarean scar pregnancy diagnosis are described. After a single dose of systemic methotrexate injection, the level of serum beta-human chorionic gonadotropin decreased in two of the women, while fetal activity was observed in the other two women. In the latter patients, methotrexate was injected under transvaginal ultrasound guidance into the gestational sac. As a result, the serum beta-human chorionic gonadotropin level first increased and then decreased in these patients. During the follow-up period, all the patients were stable and no complications were observed. Serum beta-human chorionic gonadotropin levels reached the non-pregnancy range from 4 to 9 weeks after treatment. Conclusion When diagnosed at early gestation, cesarean scar pregnancy can be treated successfully with methotrexate administration alone. The clinicians should be aware that the beta-human chorionic gonadotropin level may initially increase after methotrexate injection in some patients. However, the final outcome will be promising if the patients remain stable.

Maintaining maternal and fetal health is an important challenge in modern healthcare worldwide. Longterm passive monitoring will allow monitoring the condition of the mother and fetus for a long time, which will increase the effectiveness of medical support for a pregnant woman. The motor activity of the fetus is an important marker of its condition and the level of its nervous development. Also, the signal of fetal motor activity can be effectively recorded by passive recorders, which is critically important when organizing a passive monitoring system. The aim of this work is to analyze the applicability of passive recorders (accelerometers and gyroscopes) for recording a signal of fetal motor activity. To improve the accuracy of the analysis of fetal activity, the paper proposes an algorithm for automatic detection of episodes of fetal activity.

Fetal activity is an important indicator of fetal health and its level of neural development. To detect the critical state of the fetus, it is important to monitor the indicators of its state over a prolonged period of time. Long-term monitoring without negatively affecting the fetus and mother’s health is possible through passive methods. This work was aimed at extracting episodes of fetal motor activity from the signal obtained using an accelerometer system of long-term monitoring.

Today, the main methods for monitoring the condition of the fetus are active methods such as ultrasound. These methods are highly accurate, but cannot be used for long-term monitoring. This work is aimed at analyzing the features of building a passive long-term monitoring system based on accelerometers. The paper proposes a system consisting of three abdominal accelerometers and one reference sensor

The detailed assessment of fetal breathing movement (FBM) monitoring can be a pre-indicator of many critical cases in the third trimester of pregnancy. Standard 3D ultrasound monitoring is time-consuming for FBM detection. Therefore, this type of measurement is not common. The main goal of this research is to provide a comprehensive image about FBMs, which can also have potential for application in telemedicine. Fifty pregnancies were examined by phonography, and nearly 9000 FBMs were identified. In the case of male and female fetuses, 4740 and 3100 FBM episodes were detected, respectively. The measurements proved that FBMs are well detectable in the 20&ndash, 30 Hz frequency band. For these episodes, an average duration of 1.008 &plusmn, 0.13 s (p &lt, 0.03) was measured in the third trimester. The recorded material lasted for 16 h altogether. Based on these measurements, an accurate assessment of FBMs could be performed. The epochs can be divided into smaller-episode groups separated by shorter breaks. During the pregnancy, the rate of these breaks continuously decreases, and episode groups become more contiguous. However, there are significant differences between male and female fetuses. The proportion of the episodes which were classified into minimally 10-member episode groups was 19.7% for males and only 12.1% for females, even at the end of the third trimester. In terms of FBM detection, phonography offers a novel opportunity for long-term monitoring. Combined with cardiac diagnostic methods, it can be used for fetal activity assessment in the third trimester and make measurement appreciably easier than before.

In this paper, a method for passive registration of fetal activity as a main predictor of critical conditions of the fetus is proposed. Various types of passive sensors, including accelerometers, gyroscopes, and acoustic sensors used to record the fetal movement signal, are considered. A modeling of the source of the registered signal is carried out. A substantiation of the parameters taken into account when developing the model is also provided.

The development of passive systems for long-term monitoring of fetal activity is one of the leading tasks of modern perinatal diagnosis. Fetal activity is one of the markers of the fetal condition, by which changes in its wellbeing can be quickly determined. The introduction of a passive system of long-term monitoring into medical practice will allow medical professionals to constantly monitor the condition of the fetus, which will allow timely recognition of the development of a pathological condition. The development of such system requires careful selection of sensors, testing and debugging of the new system. In addition, the susceptibility of the fetal activity signal to the influence of numerous noises requires the development of signal processing algorithms that could be used to process large amounts of data in a short time. To solve these problems, we proposed a simulation model of the fetal activity signal source.

The human pelvis has evolved over time into a remarkable structure, optimised into an intricate architecture that transfers the entire load of the upper body into the lower limbs, while also facilitating bipedal movement. The pelvic girdle is composed of two hip bones, os coxae, themselves each formed from the gradual fusion of the ischium, ilium and pubis bones. Unlike the development of the classical long bones, a complex timeline of events must occur in order for the pelvis to arise from the embryonic limb buds. An initial blastemal structure forms from the mesenchyme, with chondrification of this mass leading to the first recognisable elements of the pelvis. Primary ossification centres initiate in utero, followed post-natally by secondary ossification at a range of locations, with these processes not complete until adulthood. This cascade of events can vary between individuals, with recent evidence suggesting that fetal activity can affect the normal development of the pelvis. This review surveys the current literature on the ontogeny of the human pelvis. Anat Rec, 300:643-652, 2017. © 2017 Wiley Periodicals, Inc.

In the medical community, fetal activity has long been used as one of the main indicators of the normal health state of pregnant women and child. Its changes can be caused of various pathological diseases. Early diagnosis in fetal activity allows the doctor to notice pathologies in time and immediately take the measures necessary to maintain the health and life of the fetus.(p)(/p)In the paper the basic methods of fetal activity analysis are considered. The general principle of processing fetal activity signals obtained from using accelerometers is described.

Fast reduction in the quantity of fetal movements can be a syndrome of physical fetal inactivity. In this paper, the identification diagnostically important indicator of fetal activity characteristics, which is indirectly an indicator of fetal well-being in pregnancy, is considered. A method for assessing the traits significance based on an integrated assessment of physiological indicators has been proposed. The described method will be used in remote monitoring systems to determine the current state of fetal health.

One of the symptoms of physical fetal inactivity is the rapid reduction of the quality of fetal movement. Today, actography is used to register fetal activity. In the paper, transducers that can be used to detect fetal movement are considered. The described algorithm for fetal movement detection can be used in remote monitoring of the state of the fetus.One of the symptoms of physical fetal inactivity is the rapid reduction of the quality of fetal movement. Today, actography is used to register fetal activity. In the paper, transducers that can be used to detect fetal movement are considered. The described algorithm for fetal movement detection can be used in remote monitoring of the state of the fetus.

The various methods of fetal activity registration are considered. The main advantages of passive methods in remote monitoring systems of fetal condition are described. A system based on the use of MEMS accelerometers is proposed, which will allow remote monitoring of fetal activity.

Fetal movements (FM) are a key factor in clinical management of high-risk pregnancies such as fetal growth restriction. While maternal perception of reduced FM can trigger self-referral to obstetric services, maternal sensation is highly subjective. Objective, reliable monitoring of fetal movement patterns outside clinical environs is not currently possible. A wearable and non-transmitting system capable of sensing fetal movements over extended periods of time would be extremely valuable, not only for monitoring individual fetal health, but also for establishing normal levels of movement in the population at large. Wearable monitors based on accelerometers have previously been proposed as a means of tracking FM, but such systems have difficulty separating maternal and fetal activity and have not matured to the level of clinical use. We introduce a new wearable system based on a novel combination of accelerometers and bespoke acoustic sensors as well as an advanced signal processing architecture to identify and discriminate between types of fetal movements. We validate the system with concurrent ultrasound tests on a cohort of 44 pregnant women and demonstrate that the garment is capable of both detecting and discriminating the vigorous, whole-body ‘startle’ movements of a fetus. These results demonstrate the promise of multimodal sensing for the development of a low-cost, non-transmitting wearable monitor for fetal movements.

In obstetrics, cardiotocography is a procedure to record the fetal heartbeat and the uterine contractions usually during the last trimester of pregnancy. It helps to monitor patterns associated with the fetal activity and to detect the pathologies. In this paper, random forest classifier is used to classify normal, suspicious and pathological patterns based on the features extracted from the cardiotocograms. The results showed that random forest classifier can detect these classes successfully with overall classification accuracy of 93.6%. Moreover, important features are identified to reduce the feature space. It is found that using seven important features, similar classification accuracy can be achieved by random forest classifier (93.3%).

Del presente estudio se concluye que: 1. La actividad fetal mostró un patrón individual, el cual se mantuvo más o menos constante 1 durante el tercer trimestre, alcanzando un máximo en la semana 35. 2. No se encontró un número absoluto o rango de la frecuencia de los movimientos fetales percibidos aplicable al tercer trimestre del embarazo.

Fetal activity parameters such as movements, fetal heart rate (FHR) and the associated parameters are essential indicators of the fetal well being, and thus, their monitoring is of high importance. Many existing monitoring systems provide partial monitoring information. For instance, most of the systems perform estimation and analysis of FHR. However, this is not enough compared to the biophysical profile or Manning test which is known to be a reference, but time consuming and not very flexible. We developed a multiple-sensor Doppler system to investigate Maning-like test. This system provides a huge amount of data which are processed in order to access the fetal activity parameters. We show here a synthesis of the main results in terms of classification.

Stillbirth is one of the most distressing complications of pregnancy and still occurs far too frequently. The rate of stillbirth has been decreasing worldwide but room for improvement remains even in high-income countries. Risk factors for stillbirth have been identified in an effort to detect those women at increased risk. However, risk factors are non-specific and do not identify most stillbirths. Strategies employed to screen the general population such as assessment of fetal activity, fetal growth screening and biomarkers have also been used to identify increased risk for stillbirth. As with clinical risk factors, these methods are non-specific. Interventions to prevent stillbirth include antenatal testing of high-risk women, ultrasonographic assessments of fetal growth and Doppler velocimetry as well as iatrogenic preterm or term delivery. Additional research into the role of these interventions and better identification of those at high risk for stillbirth will help to achieve further stillbirth reduction.

Reduced fetal movement (RFM) is commonly defined as any reduction in maternal perception of fetal activity. Perceived fetal activity may be movement of limbs, trunk or head movement, but excludes fetal hiccoughs (as this is involuntary movement). The perception of fetal movement by an expectant mother is the first, and ongoing, non-sonographic indicator of fetal viability. The “normal” pattern of fetal movements varies from pregnancy to pregnancy, and often does not become established until 28 weeks’ gestation. Many babies have particularly active periods of the day, usually corresponding to periods of maternal rest and inactivity (which may in itself reflect increased maternal awareness of fetal movement). A variable percentage of sonographically observed fetal movements are perceived by prospective mothers (commonly 30–40%, although some studies report rates as high as 80%).

This article reviews three new and emerging risk factors for stillbirth that may be modifiable or might identify a compromised fetus. We focus on fetal movements, maternal sleep, and maternal diet. Recent studies have suggested than a sudden increase in vigorous fetal activity may be associated with increased risk of stillbirth. We review the papers that have reported this finding and discuss the implications as well as potential future directions for research. There is emerging literature to suggest that maternal sleep position may be a risk for stillbirth, especially if the woman settles to sleep supine. This risk is biologically plausible. How this knowledge may be utilized to assist stillbirth reduction strategies is discussed. Finally, we examine the somewhat limited literature regarding maternal diet and pregnancy outcome. Introducing probiotics into the diet may prove useful, but further work is required. The possible next steps for research are considered, as well as some potential intervention strategies that may ultimately lead to stillbirth reduction. Refereed/Peer-reviewed

Fetal behavior can be defined as fetal activities observed or recorded with ultrasonic equipment. The introduction of three-dimensional (3D) and four-dimensional (4D) ultrasonography has enabled a more detailed morphological evaluation of the fetus, improving not only the definition but also the perception of certain fetal attitudes, such as facial expressions, in response to specific stimuli. 4D ultrasound may be a valuable tool for assessing fetal neurobehavioral development during gestation. Indeed, the follow-up of fetal activity by 4D ultrasound could allow distinction between normal and abnormal fetal behavior, which would help in early identification of fetal brain impairment.

Fetal movement counting can provide valuable information on the fetal health, as a strong decrease in the number of movements can be seen as a precursor to fetal death. Typically, assessment of fetal health by fetal movement counting relies on the maternal perception of fetal activity. The percentage of detected movements is strongly subject dependent and with undivided attention of the mother varies between 37% and 88%. Various methods to assist in fetal movement detection exist based on a wide spectrum of measurement techniques. However, these are unsuitable for ambulatory or long-term observation. In this paper, a novel low-complexity method for fetal movement detection is presented based on amplitude and shape changes in the abdominally recorded fetal ECG. This method was compared to a state-of-the-art method from the literature. Using ultrasound-based movement annotations as ground truth, the presented method outperforms the state-of-the-art abdominal-ECG based method, with a sensitivity, specificity, and accuracy of 56%, 68%, and 63%, respectively. Additionally, a significant reduction in algorithm complexity is achieved, possibly enabling continuous ambulatory fetal movement detection and early detection of reduced fetal motility.

A fogantatás után először a magzati szívműködés, majd a testmozgás indul meg. A mozgásokat ultrahanggal igen korán meg lehet figyelni. Kiváltó ok nem látható, ezért azt mondjuk, belső (intrinsit) indíttatásúak, autonóm módon következnek be. A spontán, nem kiváltott (stimulált), a központi idegrendszer által endogén módon létrejött mozgásképek az idegműködés (neuralis aktivitás) kifejezői. A méhen belüli mozgásaktivitást nagyrészt vagy teljesen belső tényezők váltják ki: belső motiváció. A korai mozgások többnyire a test minden izmát igénybe veszik. Eleinte aritmiások és szabálytalan időközökben jelentkeznek. A 9–12. héttől kezdve független végtagmozgások figyelhetők meg. A 24–28. héten a magzat jelentősen gyakrabban és rövidebb ideig mozog, mint a 30–39. hét között. Külső tényezők: érintés, lökés, hanghatás, hőmérséklet-változás a magzatból (válasz)reakciót válthat ki, ami testmozgásban nyilvánul meg. A magzatmozgások keletkezését, szervezettségét, egymással való kapcsolatát az etológusok, a gyakoriságát pedig a perinatológusok (szülészek) vizsgálják, tanulmányozzák. A két tudományos szakma közös vizsgálati alanya a magzat, de a cél kissé eltér, ezért határvonalat a kettő között nehéz húzni, mert határuk elmosódott, nemegyszer át is lépik azt, mert érdeklődési területük összefolyik. A magzat ténykedésének megfigyelésére a szülészeknek van módjuk, ezért a magzati etológia és perinatológia szerepköre összeolvad. A szülészek érdeklődési köréből adódik a magyarázat, hogy a közlemények mintegy négyötöde a terhesség második felében észlelt magzatmozgásokkal foglalkozik, sokkal kevesebb a gestatio első felében jelentkező magzatmozgásokkal foglalkozó közlemény.

Recently, frequency domain and entropy analysis of fetal heart rate (FHR) have been assessed in several studies, providing new insights into physiologic regulatory mechanisms, constituting appealing tools for pharmacodynamic assessment, namely during fetal life. There is evidence that entropy and frequency domain analysis convey information on cortical and autonomic nervous system activities, respectively. Use of internal versus external FHR acquisition sensors and the signal sampling frequency may dramatically affect results. Most FHR frequency domain indices are significantly increased with rising fetal activity, namely during active wakefulness and active sleep, whereas the opposite occurs with nonlinear indices. This is in favour of increased activity of the autonomous nervous system and decreased activity of the central nervous system complexity control systems, during periods of fetal activity. Progression of labor is associated with a significant increase in FHR frequency domain indices, whereas entropy indices are significantly decreased. This denotes activation of the autonomic nervous system in the final minutes of labour, associated with decreased central nervous system activity. The emerging knowledge on FHR frequency domain and entropy analysis substantiates a continued interest of these methods in evaluation of the fetal pathophysiologic regulatory mechanisms, and opens new perspectives for clinical and pharmacodynamic assessment.

Maternal perception of fetal movements is widely used as a marker of fetal viability and well-being. A reduction in fetal movements is associated with fetal hypoxia, increased incidence of stillbirth and fetal growth restriction (FGR). Therefore, a reduction in fetal movements has been proposed as a screening tool for FGR or fetal compromise. The problem of this approach is that there is no widely accepted definition of reduced fetal activity or 'alarm limits', and pregnant women are currently given a wide range of non-evidence-based advice. We have reviewed the background of published definitions and their potential usefulness in screening. A formal meta-analysis of these studies is not possible due to variation in methodology and definitions of reduced fetal movements. Assessment of fetal movements using formal fetal movement counting has shown equivocal results. Importantly, in all studies, there was a decrease in perinatal mortality suggesting a beneficial role for raising maternal awareness of fetal movements. Most studies implemented limits to define reduced fetal movements based on small groups of high risk pregnancies and obsolete counting methodology. A single case-control study developed 'normal limits' in a low risk population, and successfully implemented it prospectively for screening. At present, there is no evidence that any absolute definition of reduced fetal movements is of greater value than maternal subjective perception of reduced fetal movements in the detection of intrauterine fetal death or fetal compromise. Further investigation is required to determine an effective method of identifying patients with reduced fetal movements and to determine the best subsequent management.

Introduction: Counting fetal movements may lead to timely assess fetal health and prevent the adverse effects of pregnancy. Aim: The aim of this study was to determine the effect of fetal movement counting on pregnancy outcomes. Materials and Methods: In a randomized controlled trial, 208 women with singleton pregnancy were randomly divided into two groups of fetal movement counting and control. Pregnancy outcomes were compared between the two groups. Data were analysed with SPSS and p