Summary of: Machine Learning Analysis for Remote Prenatal

Care
Abstract
This study addresses the high maternal and fetal mortality rates in the Philippines due to the lack of
health professionals and quality healthcare in rural areas. It proposes using a Telemedicine
framework for prenatal care, which includes patient information input, a mobile application, a cloud-
based server, and a machine learning system. The study tested four algorithms and found that the
Random Forest Decision Tree was the most effective, with a high accuracy score. The results were
visualized in an Android mobile application to identify high-risk pregnancies.

I. INTRODUCTION
The paper discusses the United Nations Sustainable Development goal of promoting good health
and well-being for all age groups, particularly focusing on the aim of reducing maternal deaths to
70 per 100,000 live births by 2030. Despite global technological advancements in health, some
countries, especially developing ones, face challenges in providing adequate prenatal care. In the
Association of Southeast Asian Nations (ASEAN) Region, the Philippines has a high maternal
mortality rate with a low annual decrease.

A. Limited Access to Prenatal care Services

The research paper highlights the limited access to prenatal care services in the country. Prenatal
care is crucial for screening and treating health conditions during pregnancy to prevent adverse
outcomes. The 2011 Family Health Survey revealed that the majority of women received prenatal
care from a health provider, but only 33% saw a doctor while around 55% saw midwives or
community health workers. Poor accessibility and challenges faced by health workers indicate a
need to reevaluate strategies for prenatal care.

B. Telemedicine Set-up for Prenatal Care

The research paper discusses the potential of telemedicine for prenatal care, highlighting its
benefits in remote areas with limited healthcare resources. It emphasizes the integration of wired
and wireless medical data transmission to alleviate pressure on healthcare providers and improve
access to maternal and child health services. The paper also explores the application of machine
learning in telemedicine setups, using sensors, data transmission methods, databases, analytics
systems, and visualization systems to enhance remote monitoring and diagnosis.

C. Objectives
The study aims to develop a telemedicine system for pregnant women in the Philippines.
Objectives include creating a mobile app for inputting and viewing vital data, connecting the app to
a cloud database, using machine learning to predict fetal health, and optimizing algorithm
efficiency. Steps for optimization and evaluation involve pre-processing the dataset, selecting
efficient algorithms, tuning hyperparameters, and comparing performance to previous studies,
particularly Akbulut's results.

II. REVIEW OF RELATED LITERATURE

A study by Senior Members of the IEEE from Netherlands used machine learning techniques,
specifically Artificial Neural Network, to assess the risk of abnormalities in the first trimester of
pregnancy. They utilized nine parameters, including maternal age and medical history, to predict
aneuploidies. The study assessed various statistical methods for accuracy and precision, and
found that deep learning algorithms could aid in diagnosing fetal health. The research suggests
that similar machine learning methods could have applications in telemedicine, including mobile
services and prediction systems.

B. Online Prenatal Care Models

The research paper discusses the recommendation for flexible prenatal care visit schedules based
on individual expectant mother's needs, with additional visits for high-risk pregnancies and fewer
visits for low-risk ones. Studies suggest that the current high number of visits for low-risk
pregnancies may be unnecessary, leading to a study on implementing a new prenatal care model
using remote methods, including online messaging and social media communities. The paper
proposes adapting telemedicine with machine learning analytics to provide portable remote care
and personalized support for pregnant women in rural areas.

C. Results of previous studies in telemedicine for prenatal care

The C. Results of previous studies in telemedicine for prenatal care section discusses the
performance of previous studies using machine learning for fetal health prediction. The table
presents the results of studies involving fetal heart monitoring, ECG, and maternal history,
providing a basis for testing machine learning algorithms. One specific study focused on uses a
simple dataset to predict fetal health status using a Decision Tree Algorithm and included remote
diagnosis and additional features like BMI index.

III. METHODOLOGY
The study's methodology involves a system with four main components: patient information
collection, an Android Studio mobile app, a Google Firestore cloud database, and a Python-based
Machine Learning system. Patient information and the mobile app make up the data acquisition
system, sending data to the cloud server and storing patient profiles for analysis. The software
application stores patient profiles, records prenatal check-ups, computes parameters for doctors'
decision-making, and updates the mother's status after each visit.

B. Mobile Application Interface

The mobile application was developed using the Android Studio Integrated Development
Environment for accessibility on low-cost Android devices. It consists of sections sorting patients
based on prenatal care visits, with each visit page having a list of current patients and an option to
add new patients. Input fields include patient details, medical history, and lifestyle choices, stored
on a cloud database for a machine learning system. The system's output is displayed in a "Patient
Data Sheet" page, indicating normal or abnormal pregnancy risks.

1) Pre-Processing the dataset

The pre-processing of the dataset involves using maternal history data from 96 pregnant women
for algorithm training and testing. The dataset contains 97 fetuses and 23 features related to
maternal age, fetal age, delivery number, alcohol consumption, and genetic history. Nine significant
features were selected based on previous studies and medical recommendations. The dataset was
categorized as numerical or categorical data and underwent further data manipulation. Additionally,
four machine learning algorithms, including K-nearest neighbor, were chosen for evaluation based
on previous performance studies.

3) Training and testing of the machine learning algorithms

The machine learning algorithms were trained and tested using Python and the sklearn library. The
training sessions aimed to generate the algorithm needed for prediction, while the testing sessions
evaluated the algorithm's performance. The dataset was split, with 20% randomly chosen for
testing and the rest for training. Hyperparameters were tuned after each evaluation, taking into
account the unique properties and computation methods of each algorithm.

4) Evaluate the performance parameters

The performance of each algorithm was evaluated based on accuracy, confusion matrix, and
classification of Normal (N) and Abnormal (P) cases. The Random Forest Decision Tree algorithm
performed best with 98.7% accuracy during training and 90% during testing. It outperformed
Akbulut's accuracy and precision due to its optimization, lower overfitting, and improved feature
selection. Increasing the dataset size and involving local experts would enhance the algorithm's
performance. In terms of application development, interface design and communication features
can be improved for different stakeholders.