ECG Analysis of Neonatal Asphyxia

Abstract

Birth asphyxia is one of the primary causes of neonatal death. It refers to the lack of oxygen in the gas exchange to the fetus or the blood flow of the neonate before, during, or after birth. Most of these deaths occur in low- and middle-income countries, and due to lack of evidence and available information, it is challenging to reduce these deaths. Recent studies have shown that monitoring the heart rate can indicate what type of assistance the neonate requires. For this specific cause, Laerdal Medical has developed a newborn heart rate meter called NeoBeat. This device aims to give immediate information about the heart, which hopefully can lead to faster and better help during resuscitation. This thesis studies the electrocardiogram (ECG) signals collected by the NeoBeat, and the airway pressure signals from the face-mask ventilation collected by an old prototype of the Laerdal newborn resuscitation monitor (LNRM). The signals are recorded during newborn resuscitation at the Stavanger University Hospital (SUS), Norway. These collections are a part of the Safer Birth project, which focuses on increasing newborn survival. This thesis aims to synchronize the two devices, extract ECG sections immediately before and after the positive pressure ventilation (PPV) and further analyze the morphological characteristics of the PQRST complex in the ECG signal. The results from the ECG analysis show that the heart rate increased significantly in 50% of the neonates receiving PPV, and 87.5% had an ST elevation immediately after the PPV had been given. However, the findings in this thesis are inconclusive due to a very limited dataset. The introduced proposed methods work adequately for the given dataset but must be tested and confirmed on a larger dataset.

Birth asphyxia is one of the primary causes of neonatal death. It refers to the lack of oxygen in the gas exchange to the fetus or the blood flow of the neonate before, during, or after birth. Most of these deaths occur in low- and middle-income countries, and due to lack of evidence and available information, it is challenging to reduce these deaths. Recent studies have shown that monitoring the heart rate can indicate what type of assistance the neonate requires. For this specific cause, Laerdal Medical has developed a newborn heart rate meter called NeoBeat. This device aims to give immediate information about the heart, which hopefully can lead to faster and better help during resuscitation. This thesis studies the electrocardiogram (ECG) signals collected by the NeoBeat, and the airway pressure signals from the face-mask ventilation collected by an old prototype of the Laerdal newborn resuscitation monitor (LNRM). The signals are recorded during newborn resuscitation at the Stavanger University Hospital (SUS), Norway. These collections are a part of the Safer Birth project, which focuses on increasing newborn survival. This thesis aims to synchronize the two devices, extract ECG sections immediately before and after the positive pressure ventilation (PPV) and further analyze the morphological characteristics of the PQRST complex in the ECG signal. The results from the ECG analysis show that the heart rate increased significantly in 50% of the neonates receiving PPV, and 87.5% had an ST elevation immediately after the PPV had been given. However, the findings in this thesis are inconclusive due to a very limited dataset. The introduced proposed methods work adequately for the given dataset but must be tested and confirmed on a larger dataset.