Towards an efficient prognostic model for fetal state assessment

Monitoring signals such as fetal heart rate (FHR) are important indicators of fetal well-being. Computer-assisted analysis of FHR patterns has been successfully used as a decision support tool. However, the absence of a gold standard for the building blocks decision-making in the systems design process impairs the development of new solutions. Here we propose a prognostic model based on advanced signal processing techniques and machine learning algorithms for the fetal state assessment within a comprehensive evaluation process. Feature-engineering-based and time-series-based machine learning classifiers were modeled into three data segmentation schemas for CTU-UHB, HUFA, and DB-TRIUM datasets and the generalization performance was assessed by a two-way cross-dataset evaluation. It has been shown that the feature-based algorithms outperformed the time-series ones on data-limited scenarios. The Support Vector Machines (SVM) obtained the best results on the datasets individually: specificity (85.6% ) and sensitivity (67.5%). On the other hand, the most effective generalization results were achieved by the Multi-layer perceptron (MLP) with a specificity of 71.6% and sensitivity of 61.7%. The overall process provided a combination of techniques and methods that increased the final prognostic model performance, achieving relevant results and requiring a smaller amount of data when compared to the state-of-the-art fetal status assessment solutions. •A custom-made prognostic model within a systematic design process was proposed.•Nine binary classification algorithms were compared.•Extensive data-driven evaluation was carried.•The resulting design recommendations improved the model performance.