Prenatal Telemedicine – Advances in Fetal Monitoring

Current medical research aims to continuously improve diagnostic tools, and thus to develop new assessment methods, less invasive and when long-term monitoring is the case, as in telemonitoring systems less annoying for the patient. Many improvements of clinical investigations are directed by cost reduction; therefore, upgrading existing inexpensive techniques such as the direct recording of biosignals from the body surface is of utmost interest (Groves, 2008). Currently, research and development are mainly focused on offering reliable medical devices and techniques for disabled and elderly people (Alemdar et al., 2010; Feng et al. 2010; Tay, 2009; Mestre, 2005; Corchado, 2010; Fleury, 2010). Concomitantly, there are ethical and social aspects that make medical care also focus on the first years of life, including the prenatal period, since disorders and handicaps acquired during this time will be long lasting and an extreme load for the subject, for the family, and for the society, as well. Since these individuals are not autonomous, but totally dependent on the adults, the society is also responsible for their health for obvious ethical reasons. Therefore, prenatal health care is an important topic in biomedical research, and fetal monitoring is one of its most important components (Di Lieto et al., 2008; Ippolito et al., 2003; Kosa et al., 2008; Hod and Kerner, 2003; Dalfra, 2009; Kerner, 2004; Di Lieto, 2002). Fetal electrocardiogram (fECG) and electroencephalogram (fEEG) can be used to investigate the general wellbeing and the brain development. The current clinical methods are mainly based on the fetal heart rate variability (fHRV) analysis (Kovacs et al., 2000; Varady et al., 2003; Horvath et al., 2007). Currently, the noninvasive cardiotocographic technique is the standard clinical approach because its use is possible during both pregnancy and labor. Alternatively, the fetal Doppler ultrasound is used during pregnancy, but not during labor (1) because of its sensitivity to the movement either of the mother or of the fetus, and (2) because of the errors induced by the uterine activity. Furthermore, the side effect of long-term ultrasonic exposure on the fetus and young infants is not completely clear, and that is why this method is not recommended for