Fetal brain injury

Early and reliable detection of fetal brain injury, often studied, in part, via proxy of asphyxia detection remains an unsolved challenge in fetal health monitoring with major ramifications for prevention of brain injury, unnecessary cesarian section and multiM$ malpractice law suits. Using the fetal sheep model, a well-established model of human pregnancy and fetal development, my team has shown that fetal heart rate (FHR) variability (HRV) can be used as a non-invasive tool to detect fetal asphyxia near-term better than currently-available FHR monitoring. In preclinical and clinical studies, we showed why current FHR monitors are limited in the ability to detect fetal acidemia.

Recently, we progressed past the detection of acidemia per se toward the detection of the individual cardiovascular decompensation event in fetus, an important sentinel of incipient brain injury, using some machine learning techniques.

a. Frasch MG et al. (2009). Heart rate variability analysis allows early asphyxia detection in ovine fetus. Reprod Sci. 16(5):509-17. PMID: 19164481.

b. LD Durosier et al. (2014). Sampling rate of heart rate variability impacts the ability to detect acidemia in ovine fetuses near-term. Front. Pediatr. doi: 10.3389/fped.2014.00038. PMID: 24829897.

c. Xuan Li et al. Sampling frequency of fetal heart rate impacts the ability to predict pH and BE at birth: a retrospective multi-cohort study. Fast Track Communication. Physiol Meas. 2015 May;36(5):L1-12. doi: 10.1088/0967-3334/36/5/L1.

d. Nathan Gold, Martin G Frasch Christophe Herry, Bryan S Richardson, Andrew JE Seely and Xiaogang Wang. A Doubly Stochastic Change Point Detection Algorithm for Noisy Biological Signals. 2018. Frontiers in Physiology. https://doi.org/10.3389/fphys.2017.01112 bioRxiv 106088; doi: https://doi.org/10.1101/106088

e. Nathan Gold, Christophe L. Herry, Xiaogang Wang, Martin G. Frasch. Fetal cardiovascular decompensation during labor predicted from the individual heart rate: a prospective study in fetal sheep near term and the impact of low sampling rate. arXiv:1911.01304 [q-bio.QM]