Currently, the primary technology used to assess fetal wellbeing is that of ultrasound based cardiotocography (CTG). However, ultrasound devices typically utilise bulky sensors which may drop out with fetal movement, often needing to be repositioned by the midwife or obstetrician. In this project we are developing new methods to monitor fetal wellbeing using an emerging technology known as non-invasive fetal electrocardiography (NI-FECG).

One feature of NI-FECG recordings proposed for identifying fetal distress is the T/QRS ratio, which has been indicated to change in response to fetal hypoxia. As the T/QRS ratio measures characteristics of the heart’s electrical activity in 3D space (represented as the vectorcardiogram), it is critical to understand how changes in the vectorcardiogram and maternal/fetal body composition may influence the reliability of this feature.

Publications

• E. Keenan, C. K. Karmakar, and M. Palaniswami, “The effects of asymmetric volume conductor modeling on non-invasive fetal ECG extraction,” Physiol. Meas., vol. 39, no. 10, p. 105013, 2018.

• E. Keenan, C. K. Karmakar, and M. Palaniswami, “The Influence of Vectorcardiogram Orientation on the T/QRS Ratio Obtained Via Non-Invasive Fetal ECG,” in 2019 41st Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), Jul. 2019, pp. 1883–1886.

• E. Keenan, C. Karmakar, F. C. Brownfoot, and M. Palaniswami, “Personalized Anatomic Modeling for Noninvasive Fetal ECG: Methodology and Applications,” IEEE Transactions on Instrumentation and Measurement, vol. 70, p. 4004312, 2021 .

2. Diagnostic Markers of Pregnancy
2019 - 2022

Disorders of the placenta may lead to severe pregnancy complications such pre-eclampsia or fetal growth restriction. To identify and treat these complications more rapidly, recent work has investigated the use of novel biomarkers circulating in the maternal bloodstream. I am working with the incredible Mercy Perinatal team in identifying new biomarkers and developing predictive models to create the next generation diagnostic test for these disorders.

Publications

• T. D. Paul, R. Hastie, S. Tong, E. Keenan, R. Hiscock, and F. C. Brownfoot, “Prediction of adverse maternal outcomes in preeclampsia at term,” Pregnancy Hypertension, vol. 18, pp. 75–81, Oct. 2019 .

• T. M. MacDonald, S. Tong, J. Myers, P. Cannon, T.-V. Nguyen, E Keenan et al., “Circulating Tissue Factor Pathway Inhibitor (TFPI) is increased preceding preeclampsia diagnosis and in established preeclampsia,” Placenta, vol. 105, pp. 32–40, Feb. 2021 .

• T. Cruickshank, T. M. MacDonald, S.P. Walker, E Keenan et al., “Circulating Growth Differentiation Factor 15 Is Increased Preceding Preeclampsia Diagnosis: Implications as a Disease Biomarker,” Journal of the American Heart Association, vol. 10, no. 16, p. e020302, Aug. 2021.