Models of the maternal and fetal cardiovascular systems coupling via uterus and placenta

Complications occur in 5-10% of pregnancies, resulting every year in 2.6 million stillbirths and 303,000 maternal deaths. There is established evidence that complications and stillbirth are associated with abnormal development/adaptation of the cardiovascular system (CVS) during pregnancy. However, the literature lacks a holistic approach and only a few limited aspects have been investigated. Therefore, MEASURE aims at pursuing a holistic investigation of the CVS and the coupling between its subsystems (fetal and maternal CVS), mediated by the uterus and placenta. Synchronized Doppler and electrophysiological acquisitions will be performed to produce a unique dataset for the identification of a mathematical model describing the CVS. This will be achieved through robust and accurate extraction of time series representing the characteristics of the CVS in healthy pregnancies. Through an innovative aggregating strategy proposed to improve clinical reliability, the obtained model will be translated into a coupling map, i.e., a graphical representation of the relationships between the CVS subsystems and their variables. Being more intuitive and easier to interpret, this representation is particularly suitable for its clinical use and uptake. Finally, the comparison between the coupling maps of healthy and complicated pregnancies will allow identifying anomalies in the interactions between the CVS subsystems and designing/training a machine learning classifier to automatically discern between them. The outcomes of MEASURE will improve our understanding of the physiological mechanisms underlying pregnancy and original causes of complications, paving the way for the development of novel, powerful, diagnostic tools for timely diagnosis and, possibly, prediction of pregnancy complications. The support of academic, industrial, and clinical partners will provide all the instruments to achieve the envisioned scientific breakthroughs and favour their clinical translation.