Perinatal complications, defined as conditions that arise during pregnancy, childbirth, and the immediate postpartum period, represent a significant burden on maternal and neonatal health worldwide. Factors contributing to these disparities include limited access to quality healthcare, socioeconomic inequalities, and variations in healthcare infrastructure. Addressing these issues is crucial for improving health outcomes for mothers and newborns, particularly in underserved communities. To mitigate these challenges, we have developed an AI-enabled smartphone application designed to provide decision support at the point-of-care. This tool aims to enhance health monitoring during pregnancy by leveraging machine learning (ML) techniques. The intended use of this application is to assist midwives during routine home visits by offering real-time analysis and providing feedback based on collected data. The application integrates TensorFlow Lite (TFLite) and other Python-based algorithms within a Kotlin framework to process data in real-time. It is designed for use in low-resource settings, where traditional healthcare infrastructure may be lacking. The intended patient population includes pregnant women and new mothers in underserved areas and the developed system was piloted in rural Guatemala. This ML-based solution addresses the critical need for accessible and quality perinatal care by empowering healthcare providers with decision support tools to improve maternal and neonatal health outcomes.

In this study, we present a deep learning framework designed to integrate with our previously developed system that facilitates large-scale 1D fetal Doppler data collection, aiming to enhance data quality. This system, tailored for traditional Indigenous midwives in low-resource communities, leverages a cost-effective Android phone to improve the quality of recorded signals. We have shown that the Doppler data can be used to identify fetal growth restriction, hypertension, and other concerning issues during pregnancy. However, the quality of the signal is dependent on many factors, including radio frequency interference, position of the fetus, maternal body habitus, and usage of the Doppler by the birth attendants. In order to provide instant feedback to allow correction of the data at source, a signal quality metric is required that can run in real-time on the mobile phone. In this study, 191 DUS signals with durations mainly in the range between 5 to 10 minutes were evaluated for quality and classified into five categories: Good, Poor, (Radiofrequency) Interference, Talking, and Silent, at a resolution of 3.75 seconds. A deep neural network was trained on each 3.75-second segment from these recordings and validated using five-fold cross-validation. An average micro F1 = 97.4\% and macro F1 = 94.2\% were achieved, with F1 = 99.2\% for `Good' quality data. These results indicate that the algorithm, which will now be implemented in the midwives' app, should allow a significant increase in the quality of data at the time of capture.