A Model of the First Trimester Evaluation of Foetal Movements and Their Outcomes via Explainable Artificial Intelligence: A Multicentric Study

Foetal outcomes with reduced foetal movements in the later pregnancy are widely reported. We intend to quantify early foetal movements (FMs) through a checklist and their foetal outcomes via explainable artificial intelligence. It is a prospective observational study of 356 foetuses in the first trimester, and we were able to screen only 230 foetuses for early foetal growth restriction (FGR). Of which 26 were FGR and 204 were normal and were identified from the dataset using non-probability convenience sampling techniques. JASP 0.18.3, Jamovi 2.3.21, and Google Collaboratory were used to construct the predictive model. Ultrasound scores of more than 8 had favourable indicators of a normal foetus. CatBoost had the highest accuracy and recall of 87; the highest precision of 79 was given by random forest (RF), decision tree (DT), K-nearest neighbour (KNN), and CatBoost; and the F1 score of 83 was given by CatBoost. The lowest Hamming loss of 0.13 was obtained via CatBoost. The highest Jaccard score of 0.87 was by CatBoost. The stacked model has an accuracy of 89, a precision of 79, and a recall of 83. Shapley additive explanations (SHAP), local interpretable model-agnostic explanations (LIME), QLattice, and Anchor also provided good explanations. The created model can serve as a warning tool to obstetricians to make timely medical decisions.