The second Signal Processing and Monitoring in Labor workshop gathered researchers who utilize promising new research strategies and initiatives to tackle the challenges of intrapartum fetal monitoring. The workshop included a series of lectures and discussions focusing on: new algorithms and techniques for cardiotocogoraphy (CTG) and electrocardiogram acquisition and analyses; the results of a CTG evaluation challenge comparing state-of-the-art computerized methods and visual interpretation for the detection of arterial cord pH <7.05 at birth; the lack of consensus about the role of intrapartum acidemia in the etiology of fetal brain injury; the differences between methods for CTG analysis "mimicking" expert clinicians and those derived from "data-driven" analyses; a critical review of the results from two randomized controlled trials testing the former in clinical practice; and relevant insights from modern physiology-based studies. We concluded that the automated algorithms performed comparably to each other and to clinical assessment of the CTG. However, the sensitivity and specificity urgently need to be improved (both computerized and visual assessment). Data-driven CTG evaluation requires further work with large multicenter datasets based on well-defined labor outcomes. And before first tests in the clinic, there are important lessons to be learnt from clinical trials that tested automated algorithms mimicking expert CTG interpretation. In addition, transabdominal fetal electrocardiogram monitoring provides reliable CTG traces and variability estimates; and fetal electrocardiogram waveform analysis is subject to promising new research. There is a clear need for close collaboration between computing and clinical experts. We believe that progress will be possible with multidisciplinary collaborative research.

CIIRC Czech Technical University Prague Prague Czech Republic

Department of Electrical Engineering Eindhoven University of Technology Eindhoven the Netherlands

Department of Obstetrics and Gynecology at Stony Brook University Medical Center Stony Brook NY USA

Department of Obstetrics and Gynecology Centro Materno Infantil do Norte Centro Hospitalar do Porto Instituto de Ciências Biomédicas Abel Salazar Centro de Investigação em Tecnologias e Serviços de Saúde Instituto de Investigação e Inovação em Saúde University of Porto Porto Portugal

Department of Obstetrics and Gynecology St George's University of London London UK

Department of Obstetrics and Gynecology University of Washington Seattle WA USA

Department of Physiology University of Auckland Auckland New Zealand

Electrical and Computer Engineering Stony Brook University Stony Brook NY USA

Encino California USA

Nemo Healthcare Veldhoven the Netherlands

Nuffield Department of Women's and Reproductive Health Big Data Institute University of Oxford Oxford UK

Nuffield Department of Women's and Reproductive Health University of Oxford Oxford UK

University of Lyon Ens de Lyon University Claude Bernard CNRS Laboratoire de Physique Lyon France

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