Innovative Technologies and Signal Processing in Perinatal Medicine - Volume 2

The perinatal period ranges from the third trimester of pregnancy up to one month after birth. It is a critical phase, as some problems arising during this period can affect the entire life of the newborn. Even if this represents a quite broad field from the medical perspective, involving several specializations, for biomedical engineers this is a quite tight research niche characterized by high barriers. From a purely technical perspective, this issue is due to the intrinsic problems with the measurand accessibility and the disproportion between the small fetal signals and the stronger maternal interferences. From a broader bioengineering perspective, this is also due to both the peculiarities of fetal physiopathology, which evolves and changes during gestation, and the lack of knowledge of the underpinnings behind some clinical outcomes, particularly in labor. All these challenges require biomedical engineers to provide support in developing a deep understanding of medical and physiological aspects, and to sharpen signal processing, artificial intelligence, and data mining weapons, in order to conceive innovative solutions for the open issues. Baring this in mind, in 2018 I ignited a series of educational events, realized thanks to the collaboration and the financial contribution of the Autonomous Region of Sardinia and Sardegna Ricerche, in the wonderful framework of Sardinia, with the aim to present both the fundamentals needed to start moving some steps in the field, and the advanced (applied) techniques. The International Summer School on Technologies and Signal Processing in Perinatal Medicine (TSPPM2018) and then the second edition in 2021 (TSPPM2021) were conceived to create a multidisciplinary environment with both clinical and engineering outlines, for young researchers approaching this research niche or already active in it. This successful event also contributed to establishing a strong network of researchers from all over the world, including world-recognized top scientists and research groups. A first book collecting several book chapters inspired by the lectures presented during the TSPPM2018 was already published by Springer Nature with a positive impact. Following the success of the first volume, Innovative Technologies and Signal Processing in Perinatal Medicine – Volume 2 covers other important topics presented at TSPPM2021, and more. vii viii Preface Although many excellent books exist in the field of biomedical signal processing, machine learning, medicine, etc., no one expressly targets this specific area in a way that the aforementioned barriers could be reduced, if not destroyed. For this purpose, all the experts and scientists who participated in the production of this unique collection were asked to consider an engineering target, either new to this exciting topic, or with some previous experience, up to really advanced skills. The result is a stimulating reading with a rich bibliography and a clear didactic intention, including medical, legal, and engineering chapters. In particular, the first three chapters are dedicated to the presentation of the gynecologist’s, neonatologist’s, and coroner’s perspective of perinatal medicine, with an inspiring representation of the potentialities and opportunities for technological innovation in the field. A profound chapter on the legal issues associated with medical liability tackles the double-edged sword of technology in medicine, not only in terms of sensible data protection but also in terms of potentialities and criticalities of artificial intelligence and telemedicine systems. Then, three technical chapters cover methods and technologies for fetal monitoring and diagnosis, i.e., non-invasive techniques for neurodevelopment assessment, study of myocardial performance by Doppler ultrasound, and principles and technologies for fetal electrocardiography. A deep dive into the information processing for the solution of specific problems is then presented, with further four chapters dealing with non-linear time-frequency techniques for non-invasive fetal electrocardiography, fundamentals of information theory for the analysis of fetal heart rate variability, its analysis with Gaussian processes, and the estimation of the fetal state by signal processing and machine learning from such signals. In the end, as data availability is an important barrier for producing relevant research in the field, and considering the difficulty in obtaining fetal monitoring data, the closing chapter reviews the most important datasets for fetal electrocardiography, providing some hints also for phonocardiography and cardiotocography. Starting the International Summer School on Technologies and Signal Processing in Perinatal Medicine series, and collecting the chapters in this second volume, was difficult but I think the result deserved the lavished efforts. I sincerely thank all the authors for their excellent work and for being part of this adventure. It is a great honor for me to present to you the Innovative Technologies and Signal Processing in Perinatal Medicine book, Volume 2.