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Point-of-Care Real-Time Signal Quality for Fetal Doppler Ultrasound Using a Deep Learning Approach

In this study, we present a deep learning framework designed to integrate with our previously developed system that facilitates large-scale 1D fetal Doppler data collection, aiming to enhance data quality. This system, tailored for traditional Indigenous midwives in low-resource communities, leverages a cost-effective Android phone to improve the quality of recorded signals. We have shown that the Doppler data can be used to identify fetal growth restriction, hypertension, and other concerning issues during pregnancy. However, the quality of the signal is dependent on many factors, including radio frequency interference, position of the fetus, maternal body habitus, and usage of the Doppler by the birth attendants. In order to provide instant feedback to allow correction of the data at source, a signal quality metric is required that can run in real-time on the mobile phone. In this study, 191 DUS signals with durations mainly in the range between 5 to 10 minutes were evaluated for quality and classified into five categories: Good, Poor, (Radiofrequency) Interference, Talking, and Silent, at a resolution of 3.75 seconds. A deep neural network was trained on each 3.75-second segment from these recordings and validated using five-fold cross-validation. An average micro F1 = 97.4\% and macro F1 = 94.2\% were achieved, with F1 = 99.2\% for `Good' quality data. These results indicate that the algorithm, which will now be implemented in the midwives' app, should allow a significant increase in the quality of data at the time of capture.