Usually, clinicians assess the correct hemodynamic behavior and fetal well-being during the gestational age thanks to their professional expertise, with the support of some indices defined for Doppler fetal waveforms. Although this approach has demonstrated to be satisfactory in the most of the cases, it can be largely improved with the aid of more advanced techniques, i.e. numerical analysis and simulation. Another key aspect limiting the analysis is that clinicians rely on a limited number of Doppler waveforms observed during the clinical examination. Moreover, the use of simple velocimetric indicators for deriving possible malfunctions of the fetal cardiovascular system can be misleading, being the fetal assessment based on a mere statistical analysis (comparison with physiological ranges), without any deep physio-pathological interpretations of the observed hemodynamic changes. The use of a lumped mathematical model, properly describing the entire fetal cardiovascular system, would be absolutely helpful in this context: by targeting physiological model parameters on the clinical reliefs, we could gain deep insights of the full system. The calibration of model parameters may also help in formulating patient-specific early diagnosis of fetal pathologies. In the present work, we develop a robust parameter estimation algorithm based on two different optimization methods using synthetic data. In particular, we deal with the inverse problem of recognizing the most significant parameters of a lumped fetal circulation model by using time tracings of fetal blood flows and pressures obtained by the model. This represents a first methodological work for the assessment of the accuracy in the identification of model parameters of an algorithm based on closed-loop mathematical model of fetal circulation and opens the way to the application of the algorithm to clinical data.
翻译:通常,临床医师会利用专业专长,在多普勒胎儿波形的某些指数的支持下,评估妊娠年龄期间正确的血动行为和胎儿健康状况。虽然这种方法在多数情况下都令人满意,但在大多数情况下,如果借助更先进的技术,即数字分析和模拟,可以大大改进这种方法。限制分析的另一个关键方面是临床检查期间观察到的多普勒波形的有限数量。此外,使用简单的天体物理参数来计算胎儿心血管系统可能发生故障的情况,这可能具有误导性,因为采用简单的数学分析法(与生理范围相容)来进行胎儿评估。虽然这种方法在大多数情况下都令人满意,但对于观察到的血动力变化没有深刻的生理病理解释。使用一个粗略的数学模型来正确描述整个骨骼心血管系统,在这方面绝对有帮助:通过将生理模型模型参数定位用于临床缓解,我们可以深入了解整个系统的情况。模型参数的校正还可能帮助根据单纯的心脏心血管心血管系统模型进行早期的临床精确度评估(与生理运动相容相容),我们利用一个重要的合成路径分析模型模型来评估,我们用一个重要数据流的精确的模型来评估。