WO2011007169A1 - Détecteur de position fœtale - Google Patents

Détecteur de position fœtale Download PDF

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Publication number
WO2011007169A1
WO2011007169A1 PCT/GB2010/051150 GB2010051150W WO2011007169A1 WO 2011007169 A1 WO2011007169 A1 WO 2011007169A1 GB 2010051150 W GB2010051150 W GB 2010051150W WO 2011007169 A1 WO2011007169 A1 WO 2011007169A1
Authority
WO
WIPO (PCT)
Prior art keywords
signal
foetal
position detector
ultrasound
signals
Prior art date
Application number
PCT/GB2010/051150
Other languages
English (en)
Inventor
Frank Podd
Kirill Vjacheslavovitch Horoshenkov
Dagmar Monika Waiblinger
Original Assignee
The University Of Bradford
Bradford Teaching Hospitals Nhs Foundation Trust
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by The University Of Bradford, Bradford Teaching Hospitals Nhs Foundation Trust filed Critical The University Of Bradford
Publication of WO2011007169A1 publication Critical patent/WO2011007169A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/08—Detecting organic movements or changes, e.g. tumours, cysts, swellings
    • A61B8/0866—Detecting organic movements or changes, e.g. tumours, cysts, swellings involving foetal diagnosis; pre-natal or peri-natal diagnosis of the baby
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/107—Measuring physical dimensions, e.g. size of the entire body or parts thereof
    • A61B5/1075—Measuring physical dimensions, e.g. size of the entire body or parts thereof for measuring dimensions by non-invasive methods, e.g. for determining thickness of tissue layer
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2562/00—Details of sensors; Constructional details of sensor housings or probes; Accessories for sensors
    • A61B2562/02—Details of sensors specially adapted for in-vivo measurements
    • A61B2562/0204—Acoustic sensors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2562/00—Details of sensors; Constructional details of sensor housings or probes; Accessories for sensors
    • A61B2562/04—Arrangements of multiple sensors of the same type
    • A61B2562/046—Arrangements of multiple sensors of the same type in a matrix array
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6801—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be attached to or worn on the body surface
    • A61B5/6813—Specially adapted to be attached to a specific body part
    • A61B5/6823—Trunk, e.g., chest, back, abdomen, hip
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/08—Detecting organic movements or changes, e.g. tumours, cysts, swellings
    • A61B8/0858—Detecting organic movements or changes, e.g. tumours, cysts, swellings involving measuring tissue layers, e.g. skin, interfaces

Definitions

  • the present invention relates to a foetal position detector.
  • the present invention relates to a foetal position detector adapted to detect the location of a foetal head within a uterus.
  • the foetal position detector may be particularly suited to detecting the position of a human foetus.
  • Breech presentation refers to the orientation of a foetus in the uterus such that it will be delivered feet or buttocks first. Breech presentation accounts for approximately 3-4% of all babies at full term (greater than or equal to 37 weeks). Based on figures taken from http://www.hesonline.co.uk, there were 530,000 births in the UK in 2006/7, which equates to approximately 16,000 births involving breech presentations. Clinical evidence suggests that it is safer for babies in a breech presentation to be delivered by Caesarean section. A Caesarean section is a major surgical procedure and it is preferable to seek to prevent the need for a Caesarean section, where possible. External Cephalic Version (ECV) may be performed, whereby the foetus is manually turned to a head-first position allowing for a normal birth.
  • ECV External Cephalic Version
  • known portable ultrasound systems provide complex data and require a radiologist to interpret the information produced. They are also expensive and often require a computer system and software to analyse the data.
  • known ultrasound techniques for monitoring babies produce images displayed on a screen of the foetus within the uterus. It is not possible to extract the raw data from such a system in order to automatically detect the position of the foetus. Using conventional ultrasound to screen all women at term for breech presentation would be prohibitively expensive.
  • a foetal position detector comprising: a signal generator for generating an ultrasound signal; a transmitter for transmitting the ultrasound signal into the abdomen of a patient; a receiver for receiving reflected ultrasound signals; and a signal processor for processing the received reflected signals; wherein the signal processor is arranged to provide an output signal indicative of whether the reflected ultrasound signals include an acoustic signal indicative of reflections from a foetal skull.
  • a foetal position detector in accordance with the first aspect of the present invention allows the operator (for instance, a midwife) to locate the position of a foetal head within the uterus. From the location of the foetal head, a determination can be made whether the foetus is in a breech presentation. If it is determined that the foetus is a breech presentation then, if appropriate, ECV or other techniques may be applied in order to rotate the foetus. This reduces the risks to the foetus and the mother from a possible emergency Caesarean section or unplanned vaginal breech delivery.
  • the foetal position detector may further comprise a memory for storing the received reflected ultrasound signals.
  • the signal processor may be arranged to process the stored reflected ultrasound signals.
  • a signal pre-processor may be arranged to partially process the received reflected ultrasound signals before they are stored in the database.
  • An ultrasound transducer may form both the transmitter and the receiver.
  • the foetal position detector may comprise an array of two or more transducers.
  • the foetal position detector may comprise an array of two or more receivers surrounding the transmitter.
  • the signal processor may be arranged to process the received reflected signals to identify signals exceeding a threshold value.
  • the signal processor may be arranged to identify pairs of signals which exceed the threshold value and are separated by a time interval within a predetermined range.
  • the predetermined time interval range may correspond to a range of typical diameters of a foetal skull.
  • the signal processor may be arranged to determine the depth of the foetal skull below the patient's skin by calculating the time between the transmission of the ultrasound signal into the patients abdomen and the time of reception of the first of the pair of signals which exceed the threshold value.
  • the foetal position detector may further comprise an output device arranged to provide a visual or audible signal to an operator when the signal processor output signal indicates that the reflected ultrasound signal includes an acoustic signal indicative of a reflection from a foetal skull.
  • the transmitter, the receiver and the signal processor may be incorporated into a housing which is manipulable by an operator such that the beam path of the transmitted ultrasound signal can be changed.
  • the signal generator may be arranged to generate a burst pulse train signal.
  • a method of detecting the position of a foetus comprising: generating an ultrasound signal; transmitting the ultrasound signal into the abdomen of a patient; receiving reflected ultrasound signals; and processing the received reflected signals to provide an output signal indicative of whether the reflected ultrasound signals include an acoustic signal indicative reflections from a foetal skull.
  • Figure 1 is a system diagram for a foetal position detector in accordance with an embodiment of the present invention
  • Figure 2a schematically illustrates a front view of a transducer array forming part of a foetal position detector in accordance with an embodiment of the present invention
  • Figure 2b schematically illustrates a side view of the transducer array of figure 2a
  • Figure 2c schematically illustrates a side view of the transducer array of figure 2a illustrating focussing of beams from each individual sensor transducer
  • Figure 3 schematically illustrates a system diagram for the transducer of figure 2a illustrating the stages of signal processing and data presentation;
  • Figure 4a illustrates an exemplary transmitted ultrasound signal
  • Figure 4b illustrates an exemplary received ultrasound signal reflected from a skull
  • Figure 4c illustrates an exemplary spectrogram of the ultrasound signal reflected from a skull.
  • Embodiments of the present invention use acoustic principles to determine the orientation of the foetus using two points in the anatomy of the skull.
  • the foetal position detector comprises signal generation means to generate an ultrasound signal and transmit the signal into the uterus through the patient's skin.
  • the signal is reflected by the foetal skull, amongst other reflected signals.
  • a reflected signal is received from both the front and the back of the foetal skull.
  • These reflected signals can be isolated from the background reflected signals and used to detect the position of the foetal head. That is, an operator of the detector, such as a midwife, can move the position of the detector across the mother's abdomen until the foetal head is detected by the beam path of the transmitted ultrasound signal intersecting the foetal head.
  • the location of the foetal head within the abdomen can then be estimated from the position and orientation of the device relative to the abdomen. From the location of the foetal head within the abdomen, a determination can be made whether there is a breech presentation.
  • the foetal position detector does not, or does not only, produce an ultrasound scan image. Instead, the detector relies on the ultrasonic reflection pattern typical for a foetal skull and spinal cord.
  • certain embodiments of the present provide a simple, cheap, user friendly device that outputs a simple yes/no response for whether the foetal head has been detected (that is, whether the foetal head lies along the beam path from the foetal position detector). For instance, when the foetal skull is detected the device may produce a visual or audible output signal.
  • devices in accordance with the present invention allow the detection of a foetal skull in the presence of fat and muscular tissue.
  • FIG 1 this schematically illustrates a system diagram for a foetal skull position detector in accordance with an embodiment of the present invention.
  • the components of the foetal skull position detector are typically packaged within a metal or plastic box which is suitably sealed for use in a health care environment.
  • the foetal position detector comprises a processing and control unit 2 arranged to generate an ultrasound signal control signal to generate an ultrasound signal for transmission towards the approximate location of the foetal skull 4 and schematically illustrated as transmitted signal 6.
  • the ultrasound signal 6 is produced from the control signal at the sensor head 8, which includes at least one ultrasound transmitter 10.
  • the ultrasound transducers are separately labelled as transmit and receive, however it will be apparent to the skilled person that each transducer may perform both functions.
  • the sensor head 8 is arranged to transmit the ultrasound signal into the patient's abdomen.
  • the sensor head 8 may comprise a separate transmitter and receiver, or alternatively a number of transducer-receiver pairs may be used.
  • flesh water based gel may be smeared over the mother's skin.
  • the operator of the detector can adjust the position of the detector upon the mother's abdomen and adjust the orientation of the detector relative to the mother.
  • the sensor head 8 is arranged to transmit the ultrasound signal into the patient's abdomen along a narrow beam path of no greater than ⁇ 20° angular beam width.
  • the beam path of the transmitted ultrasound signal into the mother's abdomen can be varied in order to locate the foetal head.
  • a reflected signal indicative of a foetal skull along the beam path is received then the position of the foetus within the uterus can be estimated from the position and orientation of the sensor head 8.
  • three or more transducers 10 can be arranged in a single sensor head 8, as illustrated in figures 2a to 2c, discussed below. Reflected signals, from the foetus, the mother's internal organs and other objects are received by the sensor head 8 and the reflected signals are passed to the processing and control electronics block 2 for amplification and initial processing.
  • the processing and control unit 2 comprises a PC or microprocessor 12 which implements the functions of signal generation and received signal processing.
  • the PC 12 generates the transmitted ultrasound control signal which is passed to the sensor head 8 via a pulser (DAC) 14 and a signal conditioning block 16 before being received at the transducers 10 and used to generate a transmitted ultrasound signal 6.
  • Received ultrasound signals 18 (including signal reflections received from the front and back of the skull 4) are converted to an electrical signal at transducers 10 and passed to the PC 12 for processing via the signal conditioning block 16 and a digital scope (ADC) 20.
  • the pulser (DAC) 14 may alternatively be called a pulser / excitation source, as it need not necessarily incorporate a digital to analog converter.
  • the pulser 14 generates a waveform at the correct frequency to vibrate the or each transducer 10.
  • the waveform may be a high voltage pulse or, for instance a low voltage pulse train (for instance, approximately ⁇ 5 V).
  • the digital scope (ADC) 20 may not comprise an off-the-shelf digital scope, rather it may comprise a standard analog to digital converter arranged to convert the analog voltage waveform from the transducers 10 into a digital representation of the signal for further processing by the microprocessor.
  • the signal conditioning block 16 may only be positioned in the received signal path, and serves to amplify and filter the received signal.
  • the signal conditioning path may also comprise protection circuitry to enable the use of a single receive transducer (operating in pulser-echo mode). Signal conditioning may be required in the transmitted signal path if a multiple excitation transducer is used, in which the excitation beam is electronically steered and focussed.
  • the received ultrasound signal is amplified and processed to isolate and identified the unique acoustic signal reflected from the foetal skull, if the foetal skull is present along the current beam path.
  • the system of figure 1 is merely exemplary and the various functions of signal generation, reception and processing may be performed by separate components or systems which may be implemented in hardware or software, as illustrated in figure 3 and described below, rather than being solely implemented in a PC.
  • a foetal skull is detected then an output signal is passed from the PC 12 to a visualisation and auralisation unit 22.
  • the visualisation and auralisation unit 22 may comprise a speaker 22a and / or a display 22b.
  • the display may be an LED arranged to light up when a foetal skull is detected.
  • a speaker may be arranged to emit a beep or other signal.
  • the isolation and detection of the ultrasonic signature of the foetal head may be performed either in hardware or in software.
  • the received acoustic signal may be displayed to allow the operator to make their own independent determination as to whether a foetal skull is present along the beam path. If a foetal skull is not detected then the operator can move the position or orientation of the detector, for instance by tracking across the abdomen in a predetermined pattern until the skull is located.
  • the sensor head 8 is illustrated in greater detail, respectively in a front view and a side view and illustrating the focussing of the received ultrasound signals.
  • the sensor head includes three receivers 24 (RxI - Rx3) tilted towards the central axis of the sensor head 8 so that their ultrasonic bean patterns intersect in the direction of the central axis 26 (shown in figure 2c).
  • a single transmitter 28 (Tx) is arranged to transmit the ultrasound signal 6 towards an object 30 along the central axis 26.
  • the ultrasonic energy projected by the centre transducer 28 (Tx) is focused and it is easier to discriminate objects along the direction of the central axis by analysing the reflections arriving to individual receivers and combining the received signals in a linear or a nonlinear manner.
  • the received reflected signals are processed, typically within a programmed
  • FIG. 3 A typical block diagram for signal processing, data storage and presentation is shown in figure 3.
  • the digital signal from each of the receivers 24 is filtered from noise using a band-pass digital filter, in particular this may be an FIR (Finite Impulse Response) filter 40.
  • the filtering may be before or after digitisation at an analog to digital converter.
  • the filtered signal may then be averaged to improve the signal-to-noise ratio at signal averaging block 42.
  • Signal averaging comprises taking a series of measurements in quick succession and summing their time series. This causes the random noise to reduce compared to the desired echo signal.
  • the link to the pulser 14 is the trigger signal for performing the signal averaging.
  • the analog to digital converter (not illustrated) for digitising the received signals is correctly trigged using the pulser signal then the signal averaging may not require a trigger signal.
  • the averaged signal is cross-correlated with the transmitted signal at correlator 44 as noted above to improve the signal-to-noise-ratio.
  • the signal may also be correlated with the signal from the other receivers.
  • the signal may be stored before and / or after correlation in storage 46 and possibly used to update a signature library 48 to allow the system to improve its recognition of skull reflections if for a particular received signal it is known that a skull is present.
  • An envelope detector 50 may be used to determine the signal envelope and time delay between apparent reflections.
  • the averaged ultrasonic signal is compared at comparator 52 against those stored in the database 48 to determine if double reflections typical to those produced by a foetus skull are present in the data.
  • Cepstral analysis, linear and nonlinear combinations of the signals received on the sensors in the sensor head can be used to perform the comparison, which will be well known to the appropriately skilled person.
  • the output of comparator 52 is a signal indicating the presence or absence of a skull in the received ultrasound signal. This is passed to a visualisation block 54 and a logic block 56 which determines whether a skull is present in the processed signal based upon the results of the comparator.
  • the visualisation block and the logic block provide a drive signal for an integrated display unit 58 to display to the user a signal indicative of whether a skull has been detected along the current beam path.
  • the output of the comparator 52 may also or alternatively be passed to an auralisation block 60 to provide an aural signal to the user indicating whether a skull has been detected.
  • the generated ultrasound signal comprises a coded voltage signal which is converted to ultrasound by an ultrasound emitter within the sensor head 8.
  • An exemplary ultrasound transmitted signal 6 is illustrated in figure 4a.
  • the coded signal may be anything from a single pulse to a complex waveform.
  • a ten-sixteen cycle pulse-train code is known to provide for good results and is relatively simple to produce electronically.
  • the ultrasound signal may be typically 0.9-2.2 MHz.
  • the driving voltage is low, for instance +/-25V to minimise the risk to patients, although this may be varied, for instance on a patient-by- patient basis.
  • the period for the pulse-train may be approximately 1 ⁇ s.
  • the ultrasound pressure wave is reflected from organs within the uterus. If the pressure wave intersects a foetal skull it produces a special "double echo" signal as illustrated in the exemplary received ultrasound signal of figure 4b which is representative of a received signal where the transmitted ultrasound signal 6 intersects a foetal skull.
  • the received signal 18 comprises an initial reflection 32 from the surface of the abdomen. There then follows a double echo 34, 36 resulting from partial reflection of the wave from the convex near surface of the skull and partial reflection of the wave from the concave far surface of the skull.
  • the amplitude of the second signal may be larger than the first due to the concave geometry of the back of the skull.
  • front and “back” of the foetal skull it is meant the first intersected surface and the second intersected surface respectively which may or may not correspond to the anatomical front and back of the foetal skull according to the position of the foetus.
  • Figure 4c illustrates a spectrogram of the received ultrasound signal illustrated the reflection indicative of the front of the skull 34 and the back of the skull 36.
  • the frequency of the reflected signal is plotted against time.
  • Figure 4c also shows a weaker second echo for each of the front of skull signal and the back of skull signal.
  • the double echoes may be due to the thickness of the skull bone, which results in reflections from both surfaces of each side of the skull (from the water-skull interface and also the following skull- water interface). Additionally the double echoes may be due to the wavelength of the transmitted signal being close to the thickness of the skull bone.
  • the reflected and received pressure waves are converted into an electrical signal by the receiver or the transducer 28.
  • the electrical signal may be digitised or may be passed through a comparator to be detected (that is, a determination is made whether the signal exceeds a predetermined threshold). If the signal is digitised and the excitation signal is long then the received signal can be processed by compression techniques before signal detection. Additionally, the signal processing may be improved by cross correlating the transmitted and received signals to reduce noise and other signal processing techniques which will be well known to the appropriately skilled person.
  • the double echo if detected, indicates that the beam path intersects the foetal skull.
  • the skull diameter range is known for a particular foetus age and therefore the expected range of time intervals between the echoes is known and may be used to determine whether a skull is present in the beam path.
  • the time between the two echoes may be used to calculate an estimate of the age of the foetus.
  • the depth of the skull within the uterus can also be determined from the time delay of the reflected signal and this information may also be provided to the user.
  • figure 2 illustrates a sensor array within the sensor head 8 comprising a single central transmitter 28 and three spaced apart receivers 24.
  • the transmitter 28 and the receivers 24 may for instance each be formed from a 1 MHz or 2 MHz PZT transducer.
  • the three spaced apart receiving transducers 24 act as a synthetic aperture and have been shown to provide good directionality for the foetal position detector.
  • the foetal position detector of the present invention may be combined with a passive acoustic heart beat detection and heart position system. By detecting the position of the heart and comparing this with the relative position of the foetal skull the detection of breach presentation may be improved.
  • the amplitude of the transmitted ultrasound signal may be increased in proportion to the patient's weight and the circumference of her abdomen.
  • artificial intelligence based on a pattern recognition classifier may be used which is trained to recognise the reflection pattern of a typical foetal skull. The training may be performed using a database of ultrasonic signatures obtained from subjects involved in clinical testing of the device.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Veterinary Medicine (AREA)
  • Biophysics (AREA)
  • Pathology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Public Health (AREA)
  • Physics & Mathematics (AREA)
  • Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Dentistry (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Gynecology & Obstetrics (AREA)
  • Pregnancy & Childbirth (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Radiology & Medical Imaging (AREA)
  • Ultra Sonic Daignosis Equipment (AREA)

Abstract

L'invention porte sur un détecteur de position fœtale comprenant un générateur de signal (2) pour générer un signal ultrasonore, un émetteur (10) pour émettre le signal ultrasonore dans l'abdomen d'une patiente, un récepteur (10) pour recevoir des signaux ultrasonores réfléchis et un processeur de signal (2) pour traiter les signaux réfléchis reçus. Le processeur de signal (2) est agencé pour fournir un signal de sortie indicatif de si ou non les signaux ultrasonores réfléchis comprennent un signal acoustique indicatif de réflexions à partir d'un crâne fœtal (4).
PCT/GB2010/051150 2009-07-14 2010-07-14 Détecteur de position fœtale WO2011007169A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GB0912178.1 2009-07-14
GB0912178A GB0912178D0 (en) 2009-07-14 2009-07-14 Foetal position detector

Publications (1)

Publication Number Publication Date
WO2011007169A1 true WO2011007169A1 (fr) 2011-01-20

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PCT/GB2010/051150 WO2011007169A1 (fr) 2009-07-14 2010-07-14 Détecteur de position fœtale

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN107205720A (zh) * 2014-11-07 2017-09-26 艾因蒂克公司 一种超声适应性波束形成方法及其对经颅成像的应用

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5222485A (en) * 1990-09-17 1993-06-29 Ravinder Jerath Ultrasound labor monitoring method and apparatus
GB2273357A (en) * 1992-12-09 1994-06-15 Nicholas John Wald Non-invasive medical scanning
US5795296A (en) * 1996-03-29 1998-08-18 University Of Washington Pipeline process for automatically measuring object boundary from ultrasound image samples
JP2008099931A (ja) * 2006-10-20 2008-05-01 Toshiba Corp 医用画像診断装置、医用画像表示装置及びプログラム

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5222485A (en) * 1990-09-17 1993-06-29 Ravinder Jerath Ultrasound labor monitoring method and apparatus
GB2273357A (en) * 1992-12-09 1994-06-15 Nicholas John Wald Non-invasive medical scanning
US5795296A (en) * 1996-03-29 1998-08-18 University Of Washington Pipeline process for automatically measuring object boundary from ultrasound image samples
JP2008099931A (ja) * 2006-10-20 2008-05-01 Toshiba Corp 医用画像診断装置、医用画像表示装置及びプログラム

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
NIZARD J ET AL: "Determination of fetal head station and position during labor: a new technique that combines ultrasound and a position-tracking system", AMERICAN JOURNAL OF OBSTETRICS & GYNECOLOGY, MOSBY, ST LOUIS, MO, US LNKD- DOI:10.1016/J.AJOG.2008.10.051, vol. 200, no. 4, 1 April 2009 (2009-04-01), pages 404.E1 - 404.E5, XP026032556, ISSN: 0002-9378, [retrieved on 20090214] *

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN107205720A (zh) * 2014-11-07 2017-09-26 艾因蒂克公司 一种超声适应性波束形成方法及其对经颅成像的应用
CN107205720B (zh) * 2014-11-07 2020-08-11 艾因蒂克公司 一种超声适应性波束形成方法及其对经颅成像的应用

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