Fetal oxygen delivery and consumption and blood gases in relation to gestational age. Oxygen crosses the placenta by diffusion and placental permeability to O$_2$ is high. Thus, the fetus receives adequate amounts, but vascular Po$_2$ is much lower than after birth. Studies of sustained fetal hypoxemia and acute 40-45% hemorrhage show that hypoxemia is not tolerated whereas hemorrhage is. This suggests that if fetal Po$_2$ falls markedly, O$_2$ diffusion from blood to tissue is impaired. Uterine blood and umbilical blood flows/fetal weight fall progressively with advancing gestation. This results in fetal hypoxemia, an increase in Pco$_2$, and decrease in pH. This decreases fetal O$_2$ delivery, and in fetal lambs and horses there is a decrease in fetal O$_2$ consumption. The decrease in O$_2$ demands is linked to a decrease in fetal breathing and body movements and growth rate. The decrease in fetal motility is due to an increase in fetal plasma PGE2 concentration, which begins at ~120 days GA in sheep and is due to the prepartum rise in fetal cortisol. Also, adenosine administration to fetal lambs decreases fetal breathing and REM sleep and the plasma adenosine concentration incr
Congenital heart disease (CHD) screening from fetal echocardiography requires accurate analysis of multiple standard cardiac views, yet developing reliable artificial intelligence models remains challenging due to limited annotations and variable image quality. In this work, we propose FM-DACL, a semi-supervised Dual Agreement Consistency Learning framework for the FETUS 2026 challenge on fetal heart ultrasound segmentation and diagnosis. The method combines a pretrained ultrasound foundation model (EchoCare) with a convolutional network through heterogeneous co-training and an exponential moving average teacher to better exploit unlabeled data. Experiments on the multi-center challenge dataset show that FM-DACL achieves a Dice score of 59.66 and NSD of 42.82 using heterogeneous backbones, demonstrating the feasibility of the proposed semi-supervised framework. These results suggest that FM-DACL provides a flexible approach for leveraging heterogeneous models in low-annotation fetal cardiac ultrasound analysis. The code is available on https://github.com/13204942/FM-DACL.
Characterizing in-utero brain development is essential for understanding typical and atypical neurodevelopment. Building on prior spatiotemporal fetal brain MRI atlases, we present the CRL-2025 fetal brain atlas, a spatiotemporal (4D) atlas of the developing fetal brain between 21 and 37 gestational weeks. This atlas is constructed from MRI scans of 159 fetuses with typically developing brains using a diffeomorphic deformable registration framework integrated with kernel regression on age. CRL-2025 uniquely includes detailed tissue segmentations, transient white matter compartments, and parcellation into 126 anatomical regions. It offers significantly enhanced anatomical details over the CRL-2017 atlas and is presented along with a re-release of the CRL diffusion MRI atlas featuring newly created tissue segmentation and labels. We release de-identified, processed subject-level fetal MRI datasets used to generate CRL-2025, providing input-output transparency and reproducibility. We also provide FetalSEG, a deep learning-based multiclass segmentation tool to facilitate automatic fetal brain MRI segmentation. The CRL-2025 atlas and its tools enable scalable fetal brain MRI segmentatio
Fetal growth restriction (FGR) is a prevalent pregnancy condition characterised by failure of the fetus to reach its genetically predetermined growth potential. We explore the application of model fitting techniques, linear regression machine learning models, deep learning regression, and Haralick textured features from multi-contrast MRI for multi-fetal organ analysis of FGR. We employed T2 relaxometry and diffusion-weighted MRI datasets (using a combined T2-diffusion scan) for 12 normally grown and 12 FGR gestational age (GA) matched pregnancies. We applied the Intravoxel Incoherent Motion Model and novel multi-compartment models for MRI fetal analysis, which exhibit potential to provide a multi-organ FGR assessment, overcoming the limitations of empirical indicators - such as abnormal artery Doppler findings - to evaluate placental dysfunction. The placenta and fetal liver presented key differentiators between FGR and normal controls (decreased perfusion, abnormal fetal blood motion and reduced fetal blood oxygenation. This may be associated with the preferential shunting of the fetal blood towards the fetal brain. These features were further explored to determine their role in
Prenatal ultrasound evaluates fetal growth and detects congenital abnormalities during pregnancy, but the examination of ultrasound images by radiologists requires expertise and sophisticated equipment, which would otherwise fail to improve the rate of identifying specific types of fetal central nervous system (CNS) abnormalities and result in unnecessary patient examinations. We construct a deep learning model to improve the overall accuracy of the diagnosis of fetal cranial anomalies to aid prenatal diagnosis. In our collected multi-center dataset of fetal craniocerebral anomalies covering four typical anomalies of the fetal central nervous system (CNS): anencephaly, encephalocele (including meningocele), holoprosencephaly, and rachischisis, patient-level prediction accuracy reaches 94.5%, with an AUROC value of 99.3%. In the subgroup analyzes, our model is applicable to the entire gestational period, with good identification of fetal anomaly types for any gestational period. Heatmaps superimposed on the ultrasound images not only provide a visual interpretation for the algorithm but also provide an intuitive visual aid to the physician by highlighting key areas that need to be r
Craniofacial anomalies indicate early developmental disturbances and are usually linked to many genetic syndromes. Early diagnosis is critical, yet ultrasound (US) examinations often fail to identify these features. This study presents an AI-driven tool to assist clinicians in standardizing fetal facial axes/planes in 3D US, reducing sonographer workload and facilitating the facial evaluation. Our network, structured into three blocks-feature extractor, rotation and translation regression, and spatial transformer-processes three orthogonal 2D slices to estimate the necessary transformations for standardizing the facial planes in the 3D US. These transformations are applied to the original 3D US using a differentiable module (the spatial transformer block), yielding a standardized 3D US and the corresponding 2D facial standard planes. The dataset used consists of 1180 fetal facial 3D US images acquired between weeks 20 and 35 of gestation. Results show that our network considerably reduces inter-observer rotation variability in the test set, with a mean geodesic angle difference of 14.12$^{\circ}$ $\pm$ 18.27$^{\circ}$ and an Euclidean angle error of 7.45$^{\circ}$ $\pm$ 14.88$^{\ci
The quality of fetal MRI is significantly affected by unpredictable and substantial fetal motion, leading to the introduction of artifacts even when fast acquisition sequences are employed. The development of 3D real-time fetal pose estimation approaches on volumetric EPI fetal MRI opens up a promising avenue for fetal motion monitoring and prediction. Challenges arise in fetal pose estimation due to limited number of real scanned fetal MR training images, hindering model generalization when the acquired fetal MRI lacks adequate pose. In this study, we introduce FetalDiffusion, a novel approach utilizing a conditional diffusion model to generate 3D synthetic fetal MRI with controllable pose. Additionally, an auxiliary pose-level loss is adopted to enhance model performance. Our work demonstrates the success of this proposed model by producing high-quality synthetic fetal MRI images with accurate and recognizable fetal poses, comparing favorably with in-vivo real fetal MRI. Furthermore, we show that the integration of synthetic fetal MR images enhances the fetal pose estimation model's performance, particularly when the number of available real scanned data is limited resulting in 1
Fetal brain extraction is a necessary first step in most computational fetal brain MRI pipelines. However, it has been a very challenging task due to non-standard fetal head pose, fetal movements during examination, and vastly heterogeneous appearance of the developing fetal brain and the neighboring fetal and maternal anatomy across various sequences and scanning conditions. Development of a machine learning method to effectively address this task requires a large and rich labeled dataset that has not been previously available. As a result, there is currently no method for accurate fetal brain extraction on various fetal MRI sequences. In this work, we first built a large annotated dataset of approximately 72,000 2D fetal brain MRI images. Our dataset covers the three common MRI sequences including T2-weighted, diffusion-weighted, and functional MRI acquired with different scanners. Moreover, it includes normal and pathological brains. Using this dataset, we developed and validated deep learning methods, by exploiting the power of the U-Net style architectures, the attention mechanism, multi-contrast feature learning, and data augmentation for fast, accurate, and generalizable aut
The growing demand for prenatal ultrasound imaging has intensified a global shortage of trained sonographers, creating barriers to essential fetal health monitoring. Deep learning has the potential to enhance sonographers' efficiency and support the training of new practitioners. Vision-Language Models (VLMs) are particularly promising for ultrasound interpretation, as they can jointly process images and text to perform multiple clinical tasks within a single framework. However, despite the expansion of VLMs, no standardized benchmark exists to evaluate their performance in fetal ultrasound imaging. This gap is primarily due to the modality's challenging nature, operator dependency, and the limited public availability of datasets. To address this gap, we present Fetal-Gauge, the first and largest visual question answering benchmark specifically designed to evaluate VLMs across various fetal ultrasound tasks. Our benchmark comprises over 42,000 images and 93,000 question-answer pairs, spanning anatomical plane identification, visual grounding of anatomical structures, fetal orientation assessment, clinical view conformity, and clinical diagnosis. We systematically evaluate several s
Inflammation of the umbilical cord can be seen as a result of ascending intrauterine infection or other inflammatory stimuli. Acute fetal inflammatory response (FIR) is characterized by infiltration of the umbilical cord by fetal neutrophils, and can be associated with neonatal sepsis or fetal inflammatory response syndrome. Recent advances in deep learning in digital pathology have demonstrated favorable performance across a wide range of clinical tasks, such as diagnosis and prognosis. In this study we classified FIR from whole slide images (WSI). We digitized 4100 histological slides of umbilical cord stained with hematoxylin and eosin(H&E) and extracted placental diagnoses from the electronic health record. We build models using attention-based whole slide learning models. We compared strategies between features extracted by a model (ConvNeXtXLarge) pretrained on non-medical images (ImageNet), and one pretrained using histopathology images (UNI). We trained multiple iterations of each model and combined them into an ensemble. The predictions from the ensemble of models trained using UNI achieved an overall balanced accuracy of 0.836 on the test dataset. In comparison, the e
Artificial intelligence and medicine have a longstanding and proficuous relationship. In the present work we develop a brief assessment of this relationship with specific focus on machine learning, in which we highlight some critical points which may hinder the use of machine learning techniques for clinical diagnosis and therapy advice in practice. We then suggest a conceptual framework to build successful systems to aid clinical diagnosis and therapy advice, grounded on a novel concept we have coined drifting domains. We focus on oncology to build our arguments, as this area of medicine furnishes strong evidence for the critical points we take into account here.
Stuttering, also called stammering, is a communication disorder that breaks the continuity of the speech. This program of work is an attempt to develop automatic recognition procedures to assess stuttered dysfluencies and use these assessments to filter out speech therapies for an individual. Stuttering may be in the form of repetitions, prolongations or abnormal stoppages of sounds and syllables. Our system aims to help stutterers by diagnosing the severity and type of stutter and also by suggesting appropriate therapies for practice by learning the correlation between stutter descriptors and the effectiveness of speech therapies on them. This paper focuses on the implementation of a stutter diagnosis agent using Gated Recurrent CNN on MFCC audio features and therapy recommendation agent using SVM. It also presents the results obtained and various key findings of the system developed.
This paper proposes a knowledge-enhanced disease diagnosis method based on a prompt learning framework. The method retrieves structured knowledge from external knowledge graphs related to clinical cases, encodes it, and injects it into the prompt templates to enhance the language model's understanding and reasoning capabilities for the task.We conducted experiments on three public datasets: CHIP-CTC, IMCS-V2-NER, and KUAKE-QTR. The results show that the proposed method significantly outperforms existing models across multiple evaluation metrics, with an F1 score improvement of 2.4% on the CHIP-CTC dataset, 3.1% on the IMCS-V2-NER dataset,and 4.2% on the KUAKE-QTR dataset. Additionally,ablation studies confirmed the critical role of the knowledge injection module,as the removal of this module resulted in a significant drop in F1 score. The experimental results demonstrate that the proposed method not only effectively improves the accuracy of disease diagnosis but also enhances the interpretability of the predictions, providing more reliable support and evidence for clinical diagnosis.
Dermatological conditions affect 1.9 billion people globally, yet accurate diagnosis remains challenging due to limited specialist availability and complex clinical presentations. Family history significantly influences skin disease susceptibility and treatment responses, but is often underutilized in diagnostic processes. This research addresses the critical question: How can AI-powered systems integrate family history data with clinical imaging to enhance dermatological diagnosis while supporting clinical trial validation and real-world implementation? We developed a comprehensive multi-modal AI framework that combines deep learning-based image analysis with structured clinical data, including detailed family history patterns. Our approach employs interpretable convolutional neural networks integrated with clinical decision trees that incorporate hereditary risk factors. The methodology includes prospective clinical trials across diverse healthcare settings to validate AI-assisted diagnosis against traditional clinical assessment. In this work, validation was conducted with healthcare professionals to assess AI-assisted outputs against clinical expectations; prospective clinical
We present a semi-supervised framework for joint segmentation and classification of fetal cardiac ultrasound images. Built upon the EchoCare multi-task backbone, our method integrates SAM-Med2D for boundary refinement and leverages DINOv3 to enhance pseudo-label quality. We introduce view-specific hard masking along with a two-stage optimization strategy: an EMA phase to consolidate segmentation capabilities, followed by a Classification Fine-Tuning phase that freezes segmentation parameters and resets the classification head to recover classification performance without compromising segmentation gains. Evaluated on the FETUS 2026 leaderboard, our method achieves a Dice Similarity Coefficient at 79.99%, Normalized Surface Distance at 61.62%, and F1-score at 41.20%, validating the effectiveness of our approach for prenatal congenital heart disease screening. Source code is publicly available at: https://github.com/2826056177/zcst_fetus2026.
Adequate fetal and neonatal development depend upon the presence of a normal acid-base environment during pregnancy and the smooth transition from intra-uterine to extra-uterine life. Current methods to assess fetal pH and acid-base status are invasive and carry significant maternal and fetal risks. Given these limitations, obstetrical care providers developed the electronic fetal monitoring (EFM) system, a non-invasive tool, which evaluates beat-to-beat fetal heart rate (FHR) patterns in order to predict fetal oxygenation status in real-time. Every year, about 85 percent of the approximately 4 million live births in the United States are evaluated using EFM. Unfortunately, though there is ample physiological evidence that FHR patterns are inextricably linked to fetal acid-base status, the use of EFM has not been shown to reliably predict neonatal pH, nor has it reduced the incidence of adverse perinatal outcomes, including long-term neurological morbidity and cerebral palsy (CP). The poor specificity associated with the current interpretation of the EFM therefore leads to a paradox we have henceforth defined as the Obstetrical Paradox. In this study, we develop and seek to determi
This paper presents FeTal-SAM, a novel adaptation of the Segment Anything Model (SAM) tailored for fetal brain MRI segmentation. Traditional deep learning methods often require large annotated datasets for a fixed set of labels, making them inflexible when clinical or research needs change. By integrating atlas-based prompts and foundation-model principles, FeTal-SAM addresses two key limitations in fetal brain MRI segmentation: (1) the need to retrain models for varying label definitions, and (2) the lack of insight into whether segmentations are driven by genuine image contrast or by learned spatial priors. We leverage multi-atlas registration to generate spatially aligned label templates that serve as dense prompts, alongside a bounding-box prompt, for SAM's segmentation decoder. This strategy enables binary segmentation on a per-structure basis, which is subsequently fused to reconstruct the full 3D segmentation volumes. Evaluations on two datasets, the dHCP dataset and an in-house dataset demonstrate FeTal-SAM's robust performance across gestational ages. Notably, it achieves Dice scores comparable to state-of-the-art baselines which were trained for each dataset and label def
Brain segmentation is a fundamental first step in neuroimage analysis. In the case of fetal MRI, it is particularly challenging and important due to the arbitrary orientation of the fetus, organs that surround the fetal head, and intermittent fetal motion. Several promising methods have been proposed but are limited in their performance in challenging cases and in real-time segmentation. We aimed to develop a fully automatic segmentation method that independently segments sections of the fetal brain in 2D fetal MRI slices in real-time. To this end, we developed and evaluated a deep fully convolutional neural network based on 2D U-net and autocontext, and compared it to two alternative fast methods based on 1) a voxelwise fully convolutional network and 2) a method based on SIFT features, random forest and conditional random field. We trained the networks with manual brain masks on 250 stacks of training images, and tested on 17 stacks of normal fetal brain images as well as 18 stacks of extremely challenging cases based on extreme motion, noise, and severely abnormal brain shape. Experimental results show that our U-net approach outperformed the other methods and achieved average D
With the emergence of swept-volume ultrasound (US) probes, precise and almost real-time US volume imaging has become available. This offers many new opportunities for computer guided diagnosis and therapy, 3-D images containing significantly more information than 2-D slices. However, computer guidance often requires knowledge about the exact position of US voxels relative to a tracking reference, which can only be achieved through probe calibration. In this paper we present a 3-D US probe calibration system based on a membrane phantom. The calibration matrix is retrieved by detection of a membrane plane in a dozen of US acquisitions of the phantom. Plane detection is robustly performed with the 2-D Hough transformation. The feature extraction process is fully automated, calibration requires about 20 minutes and the calibration system can be used in a clinical context. The precision of the system was evaluated to a root mean square (RMS) distance error of 1.15mm and to an RMS angular error of 0.61 degrees. The point reconstruction accuracy was evaluated to 0.9mm and the angular reconstruction accuracy to 1.79 degrees.
Robot-Assisted Therapy (RAT) has successfully been used in Human Robot Interaction (HRI) research by including social robots in health-care interventions by virtue of their ability to engage human users in both social and emotional dimensions. Robots used for these tasks must be designed with several user groups in mind, including both individuals receiving therapy and care professionals responsible for the treatment. These robots must also be able to perceive their context of use, recognize human actions and intentions, and follow the therapeutic goals to perform meaningful and personalized treatment. Effective interactions require for robots to be capable of coordinated, timely behavior in response to social cues. This means being able to estimate and predict levels of engagement, attention, intentionality and emotional state during human-robot interactions. An additional challenge for social robots in therapy and care is the wide range of needs and conditions the different users can have during their interventions, even if they may share the same pathologies their current requirements and the objectives of their therapies can varied extensively. Therefore, it becomes crucial for