Digital instrument simulator platform to support the development of noninvasive optical NIR device for placenta monitoring.

Abstract

<h4>Significance</h4>Abnormal placental development is a major cause of adverse pregnancy outcomes, but current methods for placenta monitoring are not suitable for bedside use. Continuous-wave near-infrared spectroscopy (CW-NIRS) is an optical technique that takes advantage of the near-infrared light to provide functional measurements such as tissue oxygenation at the bedside. However, the placenta is an organ located beneath several layers of tissue, making robust measurement of placental oxygenation with a CW-NIRS device a complex task.<h4>Aim</h4>We propose a framework based on light propagation simulations to evaluate the sensitivity of CW-NIRS devices for placenta detection, along with tools to support NIRS instrument development for engineers.<h4>Approach</h4>The maternal abdomen was modeled as a four-layer structure (i.e., skin, adipose tissue, muscle, and placenta). We used a numerical solution of the diffusion equation using a finite-element method to assess the sensitivity to measure placental function under various conditions (tissue layer thickness, skin tone, tissue oxygen saturation). We used a calibration procedure to evaluate the probability of acquiring a sufficient irradiation with a CW-NIRS device. We collected ultrasound abdomen images from 142 healthy pregnant participants that we segmented and digitized to demonstrate our approach.<h4>Results</h4>With a Mini-CYRIL CW-NIRS device, we showed that placenta monitoring is not possible when using short integration time with a subject having a deep placenta ( ≥20  mm ) and dark skin tones. With an integration time of 10 s and a temporal binning of 10 points, simulations indicated that subjects with very fair skin tone have a placenta-scanning probability of 12% at a placenta depth of 20 mm and 39% at a depth of 10 mm, using a 50 mm source-detector separation. Thick skin and dark skin tones act as a filter on the NIRS signal, blocking backscattered light and leading to greater absorption in deeper tissues. The spatially resolved spectroscopy method can be used to monitor placental oxygenation with a placenta close to the surface and an oxygen saturation in the muscle layer lower than that of the placenta. The simulation of a realistic cohort of 142 maternal abdomens aimed to identify the optimal acquisition conditions for CW-NIRS devices to be used in placental monitoring.<h4>Conclusions</h4>We proposed a framework to evaluate and optimize CW-NIRS sensitivity for placenta detection. Further work is needed to improve the reliability of placental tissue oxygenation.