Systems, devices, and methods for determining fetal wellness using fetal ECG and fetal oximetry information

Abstract

Fetal electrocardiogram (ECG) information and fetal oximetry information may be used, in combination, to determine one or more indicators, or predictions, of fetal wellness, blood oxygen saturation, and / or heartrate. At times, the fetal ECG and fetal oximetry information may be input into a fetal health model to determine and / or predict fetal wellness and / or trends in fetal wellness over time. In some embodiments, the fetal ECG and fetal oximetry information may be obtained via a single, combined, device configured to obtain and / or measure the fetal ECG and fetal oximetry information via direct contact with a fetus. Additionally, or alternatively, fetal oximetry information may be measured via a transabdominal fetal oximetry sensor and / or transcervical device configured to be positioned in the vagina and contact the cervix.

Description

SYSTEMS, DEVICES, AND METHODS FOR DETERMINING FETAL WELLNESS USING FETAL ECG AND FETAL OXIMETRY INFORMATIONRelated Applications

[0001] This patent application is an INTERNATIONAL (PCT) PATENT APPLICATION claiming priority to United States Provisional Patent Application Number 63 / 763,236, filed on 25 February 2025 and entitled “SYSTEMS, DEVICES, AND METHODS FOR DETERMINING FETAL-OXIMETRY INFORMATION USING DIRECT MEASUREMENTS,” United States Provisional Patent Application Number 63 / 763,811, filed on 26 February 2025 and entitled “SYSTEMS, DEVICES, AND METHODS FOR DETERMINING FETAL-OXIMETRY INFORMATION AND / OR AN INDICATION OF FETAL WELLNESS USING DIRECT MEASUREMENTS,” United States Provisional Patent Application Number 63 / 838,523, filed on 03 July 2025 and entitled “SYSTEMS, DEVICES, AND METHODS FOR DETERMINING FETAL-OXIMETRY INFORMATION AND / OR AN INDICATION OF FETAL WELLNESS USING FETAL ECG AND / OR FETAL OXIMETRY INFORMATION,” and United States Provisional Patent Application Number 63 / 947,931, filed on 23 December 2025 and entitled “SYSTEMS, DEVICES, AND METHODS FOR DETERMINING FETAL-OXIMETRY INFORMATION AND / OR AN INDICATION OF FETAL WELLNESS USING FETAL ECG AND / OR FETAL OXIMETRY INFORMATION” all of which are incorporated by reference herein in their respective entireties.Technical Field

[0002] The present disclosure is in the field of medical devices and, more particularly, in the fields of fetal wellness, fetal oximetry, fetal pulse oximetry, fetal tissue oxygenation, and fetal heartrate determination and / or monitoring.Background

[0003] Current methods of monitoring fetal health, such as monitoring fetal heartrate, are inefficient and prone to inaccuracies when determining levels of fetal distress and, at times, provide false positive results indicating fetal distress that may result in the unnecessary performance of a Cesarean delivery. One area of interest in improving fetal health monitoring includes the use of transabdominal-fetal-oximetry.

[0004] Oximetry is a method for determining a level of oxygen saturation of a mammal’s tissue, arterial hemoglobin, and / or venous hemoglobin. A mammal’s level of oxygen saturation may provide an indication of health or overall wellness of an individual. Transabdominal-fetal-oximetry is a method of oximetry for a fetus performed by analyzing light projected into a pregnant mammal’s abdomen that reflects off the fetus contained therein and is detected by a photodetector. The optical information detected by the photodetector is analyzed to calculate fetal oximetry values that may be used to determine whether or not a fetus is in distress and / or is at risk of developing hypoxemia or hypoxia.Summary

[0005] Disclosed herein are systems, methods, and devices for receiving fetal oximetry information and fetal electrocardiogram (ECG) information for a fetus and inputting the received information into a fetal health and / or fetal health prediction model. On some occasions, the fetal oximetry information and fetal ECG information may be synchronized prior to being input into the fetal health model. An output from the fetal health model may include an indication of fetal health that is responsive to the fetal oximetry information and fetal ECG information and may be provided to an output device like a monitor or display device.

[0006] The fetal health model may be trained using, for example, fetal health information, neonatal health information, correlations between fetal health information and neonatal health information, correlations between fetal health information and fetal oximetry and / or fetal ECG information, and / or correlations between neonatal health information and fetal oximetry and / or fetal ECG information. Exemplary neonatal health information includes, but is not limited to, a result of neurological test, an Apgar score, respiratory information, pulse oximetry information, pulse, heartrate, skin color, a blood test result, and an umbilical cord blood test result, and responsiveness to stimulation. Exemplary fetal health information includes, but is not limited to, fetal oximetry information, fetal ECG information, a result of an analysis of variations of the fetal oximetry and / or fetal ECG information over time, and a result of a fetal ECG ST analysis.

[0007] The fetal oximetry information may be received from, for example, a transabdominal fetal oximetry sensor, a transcervical fetal oximetry sensor positioned proximate to the fetus, and / or a direct fetal oximetry sensor in contact with skin of thefetus and the fetal ECG information may be received from a fetal ECG sensor in contact with skin of the fetus. Additionally, or alternatively, the fetal oximetry information and the fetal ECG information may be received from a combined fetal oximetry and fetal ECG sensor device in contact with skin of the fetus.

[0008] In some embodiments, the systems, devices, and methods disclosed herein may be configured to verify a direct-measurement fetal oximetry and / or fetal ECG device is properly positioned on the fetus using the fetal ECG information and, if proper placement and / or electrical contact between the device and fetus cannot be verified an error message may be sent to the output device and / or user prior to inputting any information into the fetal health model. Verification of proper placement of the device on the fetus may be done using, for example, an impedance measurement and / or signal provided by the one or more fetal ECG leads of the device to, for example, determine and / or verify that the ECG lead is in contact with fetal skin. Additionally, or alternatively, verification of fetal skin contact may be done by, for example, determining fetal heartrate information using the fetal ECG information, receiving a fetal heartrate signal, and comparing the fetal heartrate information determined using the fetal ECG information and the received fetal heartrate signal. A result of this comparison may then be used to determine whether or not the device is properly positioned on the fetus (e.g., in contact with fetal skin), wherein if the fetal heartrate information determined using the fetal ECG information and the received fetal heartrate signal are sufficiently similar (e.g., 100% the same, 99%, 98%, 97%, 96%, 95%, or 90% the same) it may be assumed that the fetal ECG information is correct (i.e., is sufficiently similar to the received fetal heart rate signal) and, consequently, the device is properly placed on fetal skin. When the fetal heartrate information determined using the fetal ECG information and the received fetal heartrate signal are not sufficiently similar, an error message may be provided to the user and determination of fetal oximetry and / or fetal ECG information may stop until proper placement of the device on fetal skin may be verified.

[0009] Additionally, or alternatively, verification of fetal skin contact may be done by, for example, determining fetal heartrate information using the fetal ECG information, receiving maternal heartrate information, and comparing the fetal heartrate information determined using the fetal ECG information and the received maternal heartrate information to determine that the device is properly positioned on the fetus, wherein if the fetal heartrate information determined using the fetal ECG information is too similar(e.g., 70-100% the same or 99%, 98%, 97%, 96%, 95%, or 90% the same), it may be assumed that the ECG lead providing the fetal ECG information is not in contact with the fetus (e.g., is in electrical contact with maternal tissue (e.g., the uterus)) and, when this happens an error message may be sent to the output device and / or user.

[0010] Also disclosed herein are systems, methods, and devices for receiving transcervical fetal oximetry information for a fetus and determining fetal oximetry data (e.g., a fetal oxygenation value) therefrom. In some cases, the transcervical fetal oximetry information may be input into a transcervical fetal oximetry model configured to determine, or predict, fetal oximetry data using transcervical fetal oximetry information. An output from the transcervical fetal oximetry model may be received that represents and / or may be used to determine an oximetry value for the fetus and the oximetry value may be provided to an output or display device.

[0011] The fetal health model may trained using, for example, fetal health information, neonatal health information, correlations between fetal health information and neonatal health information, correlations between fetal health information and transcervical fetal oximetry information and / or correlations between neonatal health information transcervical fetal oximetry information.

[0012] Exemplary devices disclosed herein may include an ECG lead configured to be in electrical communication with skin of a fetus in utero and provide fetal ECG measurements to a communication interface and a direct-measurement-fetal-oximetry sensor comprising at least one light source configured to emit light of at least two different wavelengths into the fetus and a photodetector (also referred to herein as a “detector”) configured to detect light reflected from the fetus and provide an signal corresponding to the detected light to the communication interface. The communication interface may be in communication with the ECG lead and direct-measurement-fetal-oximetry sensor and configured to communicate data received from the ECG lead and direct-measurement-fetal-oximetry sensor to an external device such as a processor and / or computer. The communication interface may be a wired and / or wireless communication interface. The ECG lead, direct-measurement-fetal-oximetry sensor, and a portion of the communication interface may be housed by a housing that is coupled to a positioning extension configured to enable positioning the housing on fetal skin so that the ECG lead and the direct-measurement-fetal-oximetry sensor are in contact with the fetal skin and can take measurements therefrom.

[0013] On some occasions, the housing may include a first side in which the ECG lead and the direct-measurement-fetal-oximetry sensor are positioned and a second opposing side that includes a stabilization device configured to face an internal uterine wall when in situ and maintain a position of the first side against the fetal skin by, for example, expanding into space between the fetus and internal uterine wall. In some embodiments, a size and / or volume of the stabilization device may be adjustable. For example, in some instances, the stabilization device may be inflatable and include an inflation line resident in the positioning extension and a portion of the housing in communication with the stabilization device so that it may communicate fluid to and / or from the stabilization device, thereby adjusting a size and / or volume of the stabilization device. In some cases, a degree of inflation of the stabilization device may be responsive to back pressure exerted on the inflation line, ECG data, and / or data from the direct-measurement-fetal-oximetry sensor.

[0014] In In some embodiments, the device may be configured for ease of insertion and / or extraction. This may be achieved via, for example, use of lubricious coating on all, or a portion, of an exterior surface of the device and / or use of a material with a low coefficient of friction when manufacturing the device. In some instances, the device may include one or more optically-isolating features configured to minimize optical shunting and / or optically isolate the photodetector from the light source (thereby preventing direct communication from the light source and the photodetector so that only light that has passed through the fetus is detected). Additionally, or alternatively, the device may include a temperature sensor configured to, for example, take an intrauterine and / or intravaginal temperature measurement and provide an indication of same to the output device and / or user.Brief Description of the Figures

[0015] The present disclosure is illustrated by way of example, and not limitation, in the figures of the accompanying drawings in which:

[0016] FIG. 1A is a block diagram of an exemplary system for assessing fetal and / or maternal health and / or detecting and / or determining fetal hemoglobin oxygen saturation levels and / or fetal depth, consistent with some embodiments of the present disclosure;

[0017] FIG. 1 B is a block diagram of an exemplary set of components that may be included in a transabdominal-fetal-oximetry sensor and / or direct-measurement-fetal-oximetry sensor, in accordance with some embodiments of the present disclosure;

[0018] FIG. 1C is a block diagram of an exemplary transabdominal-fetal-oximetry sensor in contact with an abstraction of a maternal abdomen, in accordance with some embodiments of the present disclosure;

[0019] FIG. 1 D is a block diagram of an exemplary set of components that may be included in a direct-measurement-fetal-oximetry sensor, in accordance with some embodiments of the present disclosure;

[0020] FIG. 2A is a diagram of a top plan view of an exemplary direct-measurement-fetal-oximetry sensor, in accordance with some embodiments of the present disclosure;

[0021] FIG. 2A1A provides a schematic diagram of a top view of a first housing of a direct-measurement-fetal-oximetry sensor, in accordance with some embodiments of the present disclosure;

[0022] FIG. 2A1 B provides a schematic diagram of a cross-section view of the first housing of FIG. 2A1A, in accordance with some embodiments of the present disclosure;

[0023] FIG. 2A2A provides a schematic diagram of a top view of a second housing, in accordance with some embodiments of the present disclosure;

[0024] FIG. 2A2B provides a schematic diagram of a cross-section view of the second housing of FIG. 2A2A, in accordance with some embodiments of the present disclosure;

[0025] FIG. 2A3A provides a schematic diagram of a top view of a third housing, in accordance with some embodiments of the present disclosure;

[0026] FIG. 2A3B provides a schematic diagram of a cross-section view of the third housing of FIG. 2A3A, in accordance with some embodiments of the present disclosure;

[0027] FIG. 2A4 provides a side view of a fourth housing, in accordance with some embodiments of the present disclosure;

[0028] FIG. 2A5 provides a side, or cut-away, view of a fifth housing, in accordance with some embodiments of the present disclosure;

[0029] FIG. 2A6 provides a side, or cut-away, view of a sixth housing, in accordance with some embodiments of the present disclosure;

[0030] FIG. 2A7 provides a side, or cut-away, view of a seventh housing, in accordance with some embodiments of the present disclosure;

[0031] FIG. 2A8 provides a side, or cut-away, view of an eighth housing, in accordance with some embodiments of the present disclosure;

[0032] FIG. 2A9 provides a diagram of an active side of a ninth housing, in accordance with some embodiments of the present disclosure;

[0033] FIG. 2A10 provides a diagram of an active side of a tenth housing, in accordance with some embodiments of the present disclosure;

[0034] FIG. 2A11 provides a diagram of an active side of an eleventh housing, in accordance with some embodiments of the present disclosure;

[0035] FIG. 2B is a diagram of a side view of an exemplary direct-measurement-fetal-oximetry sensor, in accordance with some embodiments of the present disclosure;

[0036] FIG. 2C is a schematic diagram of a side view of another exemplary direct-measurement-fetal-oximetry sensor, in accordance with some embodiments of the present disclosure;

[0037] FIG. 2D is a schematic diagram of a side view of a further example of a direct-measurement-fetal-oximetry sensor, in accordance with some embodiments of the present disclosure;

[0038] FIG. 2E is a schematic diagram of a side view of a further example of a direct-measurement-fetal-oximetry sensor with a light source and detector arranged to detect maternal tissue optical property information, in accordance with some embodiments of the present disclosure;

[0039] FIG. 3A provides a schematic diagram of a top view of a first exemplary system that includes a first fetal ECG measurement device and an optional external reference electrode, in accordance with some embodiments disclosed herein;

[0040] FIG. 3B1 provides a schematic diagram of a top view of a second exemplary fetal ECG measurement device, in accordance with some embodiments disclosed herein;

[0041] FIG. 3B2 provides a schematic diagram of a cross section of a housing of the second exemplary fetal ECG measurement device of FIG. 3B1 when positioned in utero proximate to fetal skin, in accordance with some embodiments disclosed herein;

[0042] FIG. 3C provides a schematic diagram of a top view of a third exemplary fetal ECG measurement device, in accordance with some embodiments disclosed herein;

[0043] FIG. 3D1 provides a schematic diagram of a top view of a fourth exemplary fetal ECG measurement device, in accordance with some embodiments disclosed herein;

[0044] FIG. 3D2 provides a schematic diagram of a vertical cross section of a housing of the fourth exemplary fetal ECG measurement device of FIG. 3D1 , in accordance with some embodiments disclosed herein;

[0045] FIG. 3D3 provides a schematic diagram of a horizontal cross section of the fourth exemplary fetal ECG measurement device of FIG. 3D1when positioned in utero proximate to fetal skin 290, in accordance with some embodiments disclosed herein;

[0046] FIG. 3E1 provides a schematic diagram of a top view of a fifth exemplary fetal ECG measurement device, in accordance with some embodiments disclosed herein;

[0047] FIG. 3E2 provides a schematic diagram of a cross section view of a housing of the fifth exemplary fetal ECG measurement device of FIG. 3E1, in accordance with some embodiments disclosed herein;

[0048] FIG. 3E3 provides a schematic diagram of a cross section view of a housing of the fifth exemplary fetal ECG measurement device of FIG. 3E1 showing an air gap, in accordance with some embodiments disclosed herein;

[0049] FIG. 3F provides a schematic diagram of a side view of the fetal ECG measurement device of FIGs. 3A, 3B1, 3C, 3D1, or 3E1 with a stabilization device, in accordance with some embodiments disclosed herein;

[0050] FIG. 3G provides a schematic diagram of a side view of the fetal ECG measurement device of FIGs. 3A, 3B1, 3C, 3D1, or 3E1 with an extension, in accordance with some embodiments disclosed herein;

[0051] FIG. 3H provides a schematic diagram of a diagram of a top view of an exemplary fetal ECG measurement device configured for placement on a fetal head, in accordance with some embodiments disclosed herein;

[0052] FIG. 3I provides a schematic diagram of a diagram of a top view of another exemplary fetal ECG measurement device configured for placement on a fetal head, in accordance with some embodiments disclosed herein;

[0053] FIG. 3J provides a schematic diagram of a diagram of a top view of yet another exemplary fetal ECG measurement device configured for placement on a fetal head, in accordance with some embodiments disclosed herein;

[0054] FIG. 3K provides a schematic diagram of a cross section view of the exemplary fetal ECG measurement device of FIG. 3H, 31, or 3J, in accordance with some embodiments disclosed herein;

[0055] FIG. 4 provides a diagram of a combined fetal ECG and direct-measurement-fetal-oximetry sensor, in accordance with some embodiments disclosed herein;

[0056] FIG. 5A is a schematic diagram illustrating a cross-section view of a pregnant human woman with the direct-measurement-fetal-oximetry sensor of FIG.2A, a fetal ECG measurement device, or the combined fetal ECG and direct-measurement-fetal-oximetry sensor of FIG. 4 positioned within the pregnant woman’s uterus and proximate to the pregnant woman’s fetus, in accordance with some embodiments of the present disclosure;

[0057] FIG. 5B is a diagram illustrating a cross-section view of a pregnant human woman with the direct-measurement-fetal-oximetry sensor of FIG. 2C, a fetal ECG measurement device, or the combined fetal ECG and direct-measurement-fetal-oximetry sensor of FIG. 4 positioned within the pregnant woman’s uterus and proximate to the pregnant woman’s fetus, in accordance with some embodiments of the present disclosure;

[0058] FIG. 5C is a diagram illustrating a cross-section view of a pregnant human woman with the direct-measurement-fetal-oximetry sensor of FIG. 2D, a fetal ECG measurement device, or the combined fetal ECG and direct-measurement-fetal-oximetry sensor of FIG. 4 positioned within the pregnant woman’s uterus and proximate to the pregnant woman’s fetus, in accordance with some embodiments of the present disclosure;

[0059] FIG. 5D is a diagram illustrating a cross-section view of a pregnant human woman with the direct-measurement-fetal-oximetry sensor of FIG. 2E, the fetal ECG measurement device, or combined fetal ECG and direct-measurement-fetal-oximetry sensor of FIG. 4 positioned within the pregnant woman’s uterus and proximate to the pregnant woman’s fetus, in accordance with some embodiments of the present disclosure;

[0060] FIG. 6 provides a flowchart illustrating a method for generating an electrocardiogram (ECG) for a fetus in utero, in accordance with some embodiments disclosed herein;

[0061] FIG. 7 is a flowchart showing a method for determining fetal-oximetry information using a direct-measurement-fetal-oximetry sensor, in accordance with some embodiments of the present disclosure;

[0062] FIG. 8 is a flowchart showing an exemplary method for using both a transabdominal-fetal-oximetry sensor and a direct-measurement-fetal-oximetry sensor to obtain, determine, and / or validate fetal-oximetry information, in accordance with some embodiments of the present disclosure;

[0063] FIG. 9 is a flowchart showing an exemplary method for adjusting transabdominal-fetal-oximetry sensor, in accordance with some embodiments of the present disclosure; and

[0064] FIG. 10 is a flowchart showing an exemplary method for calibrating signals received from a transabdominal-fetal-oximetry sensor, in accordance with some embodiments of the present disclosure; and

[0065] FIG. 11 illustrates an exemplary method for validating transabdominally-obtained-fetal-oximetry information using direct-measurement-fetal-oximetry information, in accordance with some embodiments of the present disclosure;

[0066] FIG. 12 provides a flowchart illustrating an exemplary method for selecting a fetal heart rate signal from a plurality of fetal heart rate signals, in accordance with some embodiments of the present disclosure;

[0067] FIG. 13 provides a flowchart illustrating an exemplary method for generating a validated fetal heart rate signal and optionally using the validated fetal heart rate signal determine fetal oximetry information, in accordance with some embodiments of the present disclosure;

[0068] FIG. 14 provides a flowchart illustrating an exemplary method for determining fetal heart rate and fetal oximetry information, in accordance with some embodiments of the present disclosure;

[0069] FIG. 15 provides a flowchart illustrating an exemplary method for using optical fetal oximetry information and fetal ECG information to determine fetal heart rate, in accordance with some embodiments of the present disclosure;

[0070] FIG. 16 provides a flowchart illustrating an exemplary method for determining an indication of fetal health, in accordance with some embodiments of the present disclosure;

[0071] FIG. 17 provides a flowchart showing an exemplary method for developing, generating, updating, and / or building a model to determine and / or predict fetal wellness, in accordance with some embodiments of the present disclosure;

[0072] FIG. 18 provides a flowchart showing an exemplary method for using a fetal health model to determine and / or predict fetal wellness, in accordance with some embodiments of the present disclosure;

[0073] FIG. 19 provides a flowchart illustrating an exemplary method 1for determining fetal oximetry information, in accordance with some embodiments of the present disclosure;

[0074] FIG. 20 is a block diagram illustrating an exemplary system for developing one or more models disclosed herein, consistent with some embodiments of the present disclosure;

[0075] FIG. 21 A is a diagram illustrating a cross-section view of a pregnant human woman with a first exemplary transvaginal / transcervical fetal oximetry probe positioned within the pregnant mammal’s endocervical canal and proximate to her cervix, in accordance with some embodiments of the present disclosure;

[0076] FIG. 21 B is a diagram illustrating the first exemplary transvaginal / transcervical fetal oximetry probe positioned proximate to an approximation of maternal tissue, in accordance with some embodiments of the present disclosure;

[0077] FIG. 21 C is a diagram illustrating a cross-section view of a pregnant human woman with a second exemplary transvaginal / transcervical fetal oximetry probe positioned within the pregnant mammal’s endocervical canal and proximate to her cervix, in accordance with some embodiments of the present disclosure;

[0078] FIG. 21 D is a diagram illustrating the second exemplary transvaginal / transcervical fetal oximetry probe positioned proximate to an approximation of maternal and fetal tissue, in accordance with some embodiments of the present disclosure;

[0079] FIG. 22 is a flowchart showing an exemplary method for training and generating a transcervical fetal oximetry model, in accordance with some embodiments of the present disclosure;

[0080] FIG. 23 is a flowchart showing an exemplary method for using a transcervical fetal oximetry model to generate transcervical fetal oximetry information, in accordance with some embodiments of the present disclosure; and

[0081] FIG. 24 is a flowchart showing an exemplary method for validating fetal oximetry information using a comparison of fetal heart rate information derived from multiple sources and / or using fetal heartrate information to determine whether directly-measured fetal optical signals, transcervically-measured fetal optical signals, and / or transabdominally-measured fetal optical signals are valid enough to use for fetal oximetry calculations and / or determinations, in accordance with some embodiments of the present disclosure.

[0082] Throughout the drawings, the same reference numerals, and characters, unless otherwise stated, are used to denote like features, elements, components, or portions of the illustrated embodiments. Moreover, while the subject disclosure will now be described in detail with reference to the drawings, the description is done in connection with the illustrative embodiments. It is intended that changes and modifications can be made to the described embodiments without departing from the true scope and spirit of the subject disclosure as defined by the appended claims.DESCRIPTION

[0083] There are clinical situations in which obtaining sufficiently accurate transabdominal-fetal-oximetry information is challenging. For example, when a fetus is positioned beneath relatively thick layers of maternal tissue as may occur with a fetus of young gestational age (e.g., 15-25 weeks) and / or when a pregnant mammal has relatively thick layers of adipose tissue positioned between the abdominal epidermis and uterus, it can be difficult to illuminate the fetus with enough light to cause a sufficiently strong, or clear (i.e., not noisy), returning optical signal (i.e., an optical signal that has been diffusely reflected from within the fetal blood-containing tissues) to be reliably analyzed to determine fetal-oximetry information. In addition, it may be difficult to calibrate a transabdominal-fetal-oximetry sensor and / or signals detected by a transabdominal-fetal-oximetry sensor in certain situations due to, for example, fetal skin tone, fetal position within the maternal abdomen, geometrical considerations of an arrangement of the fetus within the maternal abdomen, and / or characteristics / behavior (e.g., scattering and / or absorption) of light as it travels through maternal and / or fetal tissue.

[0084] The systems, devices, and / or methods disclosed herein may be used to, for example, calibrate a transabdominal-fetal-oximetry sensor, directly measure fetal-oximetry information (e.g., optical signals that are incident on fetal skin) via a direct-measurement-fetal-oximetry sensor that is in contact with fetal skin, validate and / or verify fetal-oximetry information determined using a transabdominal-fetal-oximetry sensor. On some occasions, the direct-measurement-fetal-oximetry sensor disclosed herein may be used on a periodic, continuous, and / or as-needed basis during, for example, labor and delivery of a fetus to, for example, directly measure fetal-oximetry information and / or calibrate a transabdominal-fetal-oximetry sensor over time to account for changes in the geometry and / or anatomy of the pregnant mammal’s abdomen and / or a position of the fetus therein during labor and delivery.

[0085] Direct measurement of fetal electrocardiography (ECG) information via contact and / or electrical coupling with skin of a fetus via a fetal ECG measurement device is a highly accurate way to measure and / or determine fetal heart rate. The fetal ECG measurement devices and systems disclosed herein may include one or more components (e.g., leads or electrodes collectively referred to herein as “ECG leads”) configured to sense electrical changes triggering and / or corresponding to a fetal heartbeat while the fetus is in utero and at times, may be used within the uterus of a mammal pregnant with the fetus. The ECG leads may comprise gel, stainless steel, brass, gold, carbon, platinum, silver, and / or a non-polarizable material such as silver / silver chloride (Ag / AgCI), and / or combinations thereof and may be configured and / or selected to, for example, provide an improved DC offset and / or lower noise in a signal provided by the ECG leads.

[0086] The ECG lead(s) may be configured to directly contact fetal skin and / or be electrically coupled to fetal skin via a conductive fluid (e.g., amniotic fluid) by, for example, insertion into the uterus via a vaginal route so that one or more leads of the fetal ECG measurement device may contact fetal skin (e.g., cheek or back). In some embodiments, one or more of the ECG leads disclosed herein may include one or more features configured and arranged to engage with skin (e.g., scalp, back, and / or cheek) while the fetus is positioned within the uterus to, for example, improve physical contact between the fetus and the ECG lead, which may improve electrical communication between the fetus and the one or more ECG lead(s) and / or reduce amniotic and / or electrical shunting. Additionally, or alternatively, the fetal ECG measurement devices disclosed herein may be electrically coupled to fetal skin via aconductive fluid, such as amniotic fluid, via, for example, placement on the amniotic sac, which may be accomplished by, for example, positioning a fetal ECG measurement device between a uterus and the amniotic sac of a mammal pregnant with the fetus and / or contacting the amniotic sac via the internal cervical os of the pregnant mammal (e.g., inserted through the cervix to contact an unruptured amniotic sac). Additionally, or alternatively, the fetal ECG measurement devices disclosed herein may be configured to directly contact skin of a fetus’ head via a dilated (e.g., 1-10cm) cervix and / or when positioned at, for example, -1 to +3 station.

[0087] In some embodiments, an outer surface of the fetal ECG measurement devices disclosed herein may be manufactured from a material with a low coefficient of friction (e.g., smooth plastic or silicon) and / or covered and / or treated with a lubricious coating to, for example, facilitate movement of outer surface of a fetal ECG measurement device along an interior wall of the uterus, an interface between an inner wall of the uterus and an amniotic sac, cervix, and / or vagina. Additionally, or alternatively, a surface of the fetal ECG measurement devices disclosed herein configured to contact fetal skin may include a friction-inducing surface feature (e.g., texture or compound that may make a hydrogel with adhesive properties when mixed with amniotic fluid) that, for example, assists with holding the contact surface of a fetal ECG measurement device against the fetal skin and / or prevents sliding or movement of the contact surface when positioned on the fetal skin.

[0088] In some embodiments, the fetal ECG measurement devices disclosed herein may include a wand, handle, and / or positioning device (at times, collectively referred to herein as “positioning device”) configured to allow a clinician to push the fetal ECG measurement device through the vagina and cervix to contact an amniotic sac and / or fetal skin. The positioning device may be stiff enough to aid in placement of the fetal ECG measurement device but flexible enough so that it does not rupture or traumatize tissue and / or an amniotic sac during insertion and / or use. On some occasions, the wand and / or positioning device may also protect components of the fetal ECG measurement device from, for example, mechanical and / or liquid-induced damage.

[0089] The systems, devices, and methods disclosed herein overcome the safety and accuracy concerns of traditional methods of fetal ECG and heart rate monitoring especially when, for example, monitoring fetal heart rate using traditional transabdominal Doppler ultrasound is inadequate and / or use of traditional fetal scalpelectrodes is contraindicated or not available due supply-chain and / or recall-induced shortages.

[0090] FIG. 1A provides an exemplary system 100 for assessing fetal and / or maternal health, detecting optical signals that may be analyzed to determine fetal-oximetry information, determining fetal ECG and / or heartrate information, and / or determining fetal-oximetry information and / or indications of fetal distress that may, in some instances, be correlated to deoxygenation. The components of system 100 may be coupled together via wired and / or wireless communication links. In some instances, wireless communication of one or more components of system 100 may be enabled using short-range wireless communication protocols designed to communicate over relatively short distances (e.g., Bluetooth®, near field communication (NFC), radiofrequency identification (RFID), and Wi-Fi) with, for example, a computer and / or processor or personal electronic device (e.g., tablet computer or smart phone) as described below.

[0091] System 100 includes an exemplary fetal-oximetry sensor 115 that houses at least one light source 105 and at least one detector 160 and may be configured for transabdominal, transvaginal, or transcervical use. On some occasions, fetal-oximetry sensor 115 may include additional components as described herein with regard to FIGs. 1B, 1C, and / or 1D. Light source 105 may include a single or multiple light sources, and detector 160 may include a single or multiple detectors. Light source 105 may transmit light of one or more wavelengths, including near infra-red (NIR), into a pregnant mammal’s abdomen and / or directly into fetal skin. Light source 105 may be, for example, an LED, and / or a LASER that may be coupled to a fiber optic cable. On some occasions, one or more light sources 105 may be one or more fiber optic cables optically coupled to a laser and arranged in an array. In some instances, light source 105 may be tunable or otherwise user configurable, while in other instances light source 105 may be configured to emit light within a pre-defined range of wavelengths. Additionally, or alternatively, one or more filters (not shown) and / or polarizers may filter / polarize the light emitted by light sources 105 to be of one or more preferred wavelengths and / or polarizations. In some cases, these filters / polarizers may also be tunable or user configurable. An exemplary light source 105 may have a relatively small form factor and may operate with high efficiency, which may serve to, for example, conserve space and / or limit heat emitted by the light source 105. In one embodiment, light source 105 is configured to emit light in the range of 500-1100nm,600-1070nm or 850-1070nm. In some embodiments, light source 105 (or multiple light sources 105) may emit light of at least two different wavelengths (e.g., 735 and 890nm; 760 and 810 nm; or 730 and 850 nm).

[0092] Detector 160 may be one or more components configured to detect light emanating from the pregnant mammal and / or the fetus via, for example, transmission and / or back scattering and convert this light signal into an analog and / or digital, or electronic, signal. The detected signal may be communicated to a computer or processor such as computer and / or processor 150 and / or a receiver such as receiver / interface 145 via, for example, an on-board transceiver and / or a wired communication link. Exemplary detectors 160 include, but are not limited to, photodetectors and cameras. Photodetector technologies that could be employed include PN or PIN photodiodes, avalanche photodiodes, traditional photomultiplier tubes (PMTs), single photon avalanche detectors (SPADs), and / or silicon PMTs.

[0093] System 100 includes a number of optional independent sensors / sensors configured to monitor various aspects of maternal and / or fetal health that may be communicatively coupled to, for example, a timestamping device 185, a receiver / interface 145, and / or computer and / or processor 150. These sensors / sensors include a visible and near infrared spectroscopy (Vis-NIRS) adult hemoglobin sensor 125, a pulse oximetry sensor 130, a Doppler and / or ultrasound sensor 135, a uterine contraction measurement device 140, an electrocardiography (ECG) measurement device 175, and a ventilatory / respiratory signal source 195. ECG measurement device 175 may be used to determine the pregnant mammal’s heartrate, and, in some embodiments, ECG measurement device 175 may be a fetal ECG that may be used to determine the fetus’s heartrate. In some instances, ECG measurement device 175 may be used internally via, for example, placement in the endocervical canal and / or vagina. At times, placement of ECG measurement device 175 in the vagina and / or on fetal skin may be facilitated by inclusion in a direct-measurement-fetal-oximetry sensor as disclosed herein. In some embodiments, a signal from ECG measurement device 175 may be used as a trigger or to create a binarized waveform to perform other actions such as cross-correlation filtering, pulse averaging, and / or synchronous detection and / or filtering of a composite signal to isolate a fetal signal.

[0094] Fetal ECG measurement device 175 may be used to detect, monitor, and / or measure a feature of a fetus’s heart rate and / or cardiac signal via direct contact with fetal skin and / or indirect electrical coupling with the fetus via insertion into anendocervical canal of a pregnant mammal until it is in contact with fetal skin and / or is proximate enough to fetal skin to be electrically coupled thereto via, for example, a conducting fluid like amniotic fluid (e.g., inside and / or outside the amniotic sac). Once in position, the fetal ECG measurement devices 175 disclosed herein may detect electrical signals from the fetus using one or more ECG leads and, on some occasions, a reference electrode that may be in contact with maternal tissue (e.g., vaginal canal or thigh). ECG leads may be an electrode, lead, and / or sensor configured to detect an electrical signal and / or electrical potential generated by a fetus’s heart. In some embodiments, the ECG leads may be configured to provide feedback regarding whether or not fetal ECG measurement device 175 is in contact with fetal skin and / or is electrically coupled to the fetus because when it is decoupled (physically or electrically) from the fetus (e.g., an ECG lead is not in contact with fetal skin and is potentially floating in amniotic fluid surrounding the fetus in a manner that does not allow for electrical coupling of the ECG lead to the fetus), a low impedance path may exist between two ECG leads that is different from the impedance measured between these two leads when they are in contact with and / or electrically coupled to the fetus. This impedance difference can be measured using, for example, ECG lead-off detection circuitry and / or other bioimpedance measurement devices, either, or both, of which may be resident within receiver / interface 145 and / or computer and / or processor 150 and or be embodied as a separate device that may be coupled thereto In some embodiments, one or more ECG lead(s) may be positioned so that they are in physical contact with and / or electrically coupled to the fetus and additional ECG lead(s) may be positioned so that they may be in contact with, for example, maternal tissue (e.g., skin, vaginal wall, and / or uterine wall) when fetal ECG measurement device 175 is in situ within a pregnant mammal’s body / uterus.

[0095] Doppler and / or ultrasound sensor 135 may be configured to be placed on the abdomen of the pregnant mammal and may provide information regarding, for example, fetal depth, tissue layer thicknesses, fetal position, orientation, and / or heartrate. Pulse oximetry sensor 130 may be a conventional pulse oximetry sensor placed on, for example, the pregnant mammal's earlobe and / or finger to measure the pregnant mammal’s hemoglobin oxygen saturation level. Vis-NIRS adult hemoglobin sensor 125 may be placed on, for example, the pregnant mammal’s 2nd finger or earlobe and may be configured to, for example, use visible and near infrared spectroscopy to calculate the ratio of adult oxyhemoglobin to adult de-oxyhemoglobin.Vis-NIRS adult hemoglobin sensor 125 may also be used to determine the pregnant mammal’s heartrate. In some embodiments, Vis-NIRS adult hemoglobin sensor 125 may be a blood CO-oximeter, a hemoximeter, or blood gas analyzer.

[0096] Uterine contraction measurement device 140 may be configured to measure the strength and / or timing of the pregnant mammal’s uterine contractions. In some embodiments, uterine contractions may be measured by uterine contraction measurement device 140 as a function of pressure and / or force (e.g., measured in e.g., mmHg and / or pound force (Ibf)) overtime. In some instances, uterine contraction measurement device 140 is and / or includes a tocotransducer, which is an instrument that includes a pressure-sensing area that detects changes in the abdominal contour to measure uterine activity and, in this way, monitors frequency and duration of contractions. Additionally, or alternatively, uterine contractions may be measured via visible and / or near infrared spectroscopy using, for example, light received / detected by detector 160 because uterine contractions, which are muscle contractions, are oscillations of the uterine muscle between a contracted state and a relaxed state that may be observed via analysis of an optical signal detected by detector 160 because oxygen consumption of the uterine muscle during both of these stages is different and these differences may be detectable using Vis-NIRS. Additionally, or alternatively, uterine contraction measurement device 140 may employ electromyography (EMG) to measure electrical activity from the uterine muscle to detect one or more characteristics of uterine contractions during a labor and delivery process. Additionally, or alternatively, uterine contraction measurement device 140 may be an intrauterine pressure catheter (IUPC).

[0097] Measurements and / or signals from Vis-NIRS adult hemoglobin sensor 125, pulse oximetry sensor 130, Doppler and / or ultrasound sensor 135, and / or uterine contraction measurement device 140 may be communicated directly to computer and / or processor 150 and / or to receiver / interface 145 for communication to computer and / or processor 150 and display on display device 155 and, in some instances, may be considered secondary signals. In some embodiments, measurements provided by Vis-NIRS adult hemoglobin sensor 125, pulse oximetry sensor 130, a Doppler and / or ultrasound sensor 135, uterine contraction measurement device 140, ECG measurement device 175, and / or ventilatory / respiratory signal source 195 may be used in conjunction with fetal-oximetry sensor 115 to isolate a fetal contribution (alsoreferred to herein as a “fetal signal”) to an optical signal detected by detector 160 that may include light that was incident on both the pregnant mammal and fetus.

[0098] Receiver / interface 145 may be configured to receive signals and / or data from one or more components of system 100 including, but not limited to, fetal-oximetry sensor 115, Vis-NIRS adult hemoglobin sensor 125, pulse oximetry sensor 130, Doppler and / or ultrasound sensor 135, uterine contraction measurement device 140, ECG measurement device 175, and / or ventilatory / respiratory signal source 195. Communication between receiver / interface 145 and / or computer and / or processor 150 and other components of system 100 may be made using wired or wireless communication.

[0099] Receiver / interface 145 may communicate signals received from fetal ECG measurement device 175 to computer and / or processor 150 and / or output and / or printout device 180. Additionally, or alternatively, receiver / interface 145 may be configured to perform signal conditioning (e.g., analog filtering, digital filtering, amplification, etc.) upon one or more received raw ECG signal(s). Computer and / or processor 150 may act to process the received raw ECG signal(s) and / or conditioned ECG signal(s), according to, for example, one or more of the methods disclosed herein, and facilitate provision of the results (e.g., fetal heart rate and / or trends for fetal heart rate) to output and / or printout device 180. Exemplary computers 150 include desktop and laptop computers, servers, tablet computers, personal electronic devices, mobile devices (e.g., smart phones), ECG machines, and the like. Exemplary output and / or printout devices 180 include, but are not limited to, display devices (e.g., touch screen or computer monitor), user interfaces (e.g., speakers, lights, gauges), computers, printers, and health monitors.[000100] In some embodiments, receiver / interface 145 and / or computer and / or processor 150 may be configured to amplify raw, differential, and / or conditioned ECG signal(s) via, for example a differential amplifier included therein. The differential amplifier may be configured to convert the differential signal into a single-ended output.[000101] In some embodiments, output and / or printout device 180 may be configured to communicate with, and / or be resident within, processor and / or computer 150 and, in these embodiments, exemplary output and / or printout devices 180 may be embodied as computer monitors, tablet computer devices, display screens, computer monitors, and the like. Additionally, or alternatively, output and / or printoutdevice 180 may be embodied as a strip chart recorder or other printing device configured to receive a raw analog ECG signal from ECG measurement device 175 and / or receiver / interface 145 and / or a conditioned analog ECG signal from receiver / interface 145 and the analog raw and / or conditioned analog ECG signal may drive the output and / or printout device 180 (embodied as, for example, a strip chart recorder) to graph, or otherwise print out the raw and / or conditioned ECG signal and / or fetal heart rate data determined therefrom.[000102] In some instances, one or more of Vis-NIRS adult hemoglobin sensor 125, pulse oximetry sensor 130, a Doppler and / or ultrasound sensor 135, uterine contraction measurement device 140, ECG measurement device 175, and / or ventilatory / respiratory signal source 195 may include a dedicated display that provides the measurements to, for example, a user or medical treatment provider. It is important to note that not all of these sensors are used in every instance. For example, when the pregnant mammal is using fetal-oximetry sensor 115 in a setting outside of a hospital or treatment facility (e.g., at home or work) then, some of the sensors (e.g., Vis-NIRS adult hemoglobin sensor 125, pulse oximetry sensor 130, a Doppler and / or ultrasound sensor 135, uterine contraction measurement device 140, ECG measurement device 175, and / or ventilatory / respiratory signal source 195) of system 100 may not be used.[000103] In some instances, receiver / interface 145 may be configured to process or pre-process received signals so as to, for example, make the signals compatible with computer and / or processor 150 (e.g., convert an optical signal to a digital and / or an electrical signal), improve signal to noise ratio (SNR), amplify a received signal, etc. In some instances, receiver / interface 145 may be resident within and / or may be a component of computer and / or processor 150. In some embodiments, computer and / or processor 150 may amplify or otherwise condition the received detected signal so as to, for example, improve the signal-to-noise ratio.[000104] Receiver / interface 145 may communicate received, pre-processed, and / or processed signals to computer and / or processor 150. Computer and / or processor 150 may act to process the received signals, according to, for example, one or more of the methods disclosed herein, and facilitate provision of the results to display device 155. Exemplary computer and / or processors 150 include desktop and laptop computers, servers, tablet computers, personal electronic devices, mobile devices (e.g., smart phones), application specific circuits (ASICs), field programmablegate arrays (FPGAs), and the like. Exemplary display devices 155 are computer monitors, tablet computer devices, and displays provided by one or more of the components of system 100. In some instances, display device 155 may be resident in receiver / interface 145 and / or computer and / or processor 150. Computer and / or processor 150 may be communicatively coupled to a database 170, which may be configured to store instructions for executing one or more of the methods disclosed herein and / or information regarding physiological characteristic and / or combinations of physiological characteristic of pregnant mammals and / or their fetuses, impacts of physiological characteristic on light behavior, information regarding the calculation of hemoglobin oxygen saturation levels, calibration factors, and so on. In some embodiments, computer and / or processor 150 may include and / or be communicatively coupled to one or more analog front-end (AFE) integrated circuits (ICs) configured to perform oximetry (e.g., SpO2) calculations using, for example, two wavelengths of light, which may referred to herein as “oximetry wavelengths”. When analysis of three separate wavelengths of light is desired as, for example, described herein, computer and / or processor 150 may include and / or be communicatively coupled to one or more analog optical switches configured to disconnect communication of one of the oximetry wavelengths of light to AFE so that the contact sensing wavelength may be communicated to the AFE for further analysis to, for example, assess optical shunting and / or contact between direct-measurement-fetal-oximetry sensor and fetal skin. For example, in one embodiment, oximetry wavelengths may be a red wavelength projected by a first LED and infrared wavelength projected by a second LED infrared light and contact sensing wavelength may be green light projected by a green LED. In this embodiment, with an AFE configured to process only two wavelengths of light, one of the red or infrared LED may be temporarily disconnected, or switched off, periodically, as-needed, on request, etc. so that the green LED may be connected and / or switched on, which would allow for the monitoring of the green signal during the red / infrared time slots in a time-multiplexed photocurrent signal received by the AFE.[000105] Additionally, or alternatively, computer and / or processor 150 may use and / or be coupled to an AFE and a switch may not be used. Instead, the oximetry and contact sensing wavelengths may be simultaneously emitted by light source(s) of a direct-measurement-fetal-oximetry sensor and resulting signals may be detected and analyzed for fetal oximetry information and / or indications of green light within thedetected signal(s) corresponding to the oximetry wavelengths. Because the green light is highly attenuated by fetal tissue, none, or little, of the emitted green light should be detected by a detector of the direct-measurement-fetal-oximetry sensor when it is in proper contact with the fetal skin. Thus, if there is green light in the signals detected by the detector, it is an indication that the direct-measurement-fetal-oximetry sensor has lifted away from and / or is not in direct contact with fetal skin. This embodiment allows for continuous, or nearly continuous, monitoring for optical shunting and / or a failure of direct-measurement-fetal-oximetry sensor to contact fetal skin.[000106] In some embodiments, system 100 may include a ventilatory / respiratory signal source 195 that may be configured to monitor the pregnant mammal’s respiratory rate and provide a respiratory signal indicating the pregnant mammal’s respiratory rate to, for example, computer and / or processor 150. In some embodiments, ventilatory / respiratory signal source 195 may be a source of a ventilatory signal obtained via, for example, cooperation with a ventilation machine. Exemplary ventilatory / respiratory signal sources 195 include, but are not limited to, a carbon dioxide measurement device, a stethoscope, electronic acoustic stethoscope, a device that measures chest excursion for the pregnant mammal, and a pulse oximeter. Additionally, or alternatively, a signal from a pulse oximeter (e.g., pulse oximetry sensor 130 and / or Vis-NIRS adult hemoglobin sensor 125) may be analyzed to determine variations in the PPG signal that may correspond to respiration for the pregnant mammal. Additionally, or alternatively, ventilatory / respiratory signal source 195 may provide a respiratory signal that corresponds to a frequency with which gas (e.g., air, anesthetic, etc.) is provided to the pregnant mammal during, for example, a surgical procedure. This respiratory signal may be used to, for example, determine a frequency of respiration for the pregnant mammal, which may correspond to motion artifacts present in a signal detected by detector 160.[000107] In some embodiments, system 100 may include timestamping device 185 configured to timestamp a signal detected and / or generated by, for example, fetal-oximetry sensor 115, Doppler / ultrasound sensor 135, pulse oximetry sensor 130, Vis-NIRS adult hemoglobin sensor 125, uterine contraction measurement device 140, ECG measurement device 175, and / or ventilatory / respiratory signal source 195 with a timestamp that represents, for example, an event (e.g., time, or t, = 0, 10, 20, etc.) and / or chronological time (e.g., date and time) so that these signals may be synchronized in time using with the timestamp. Timestamping device 185 maytimestamp a signal via, for example, introducing a ground, acoustic, and / or optical signal into system 100 that may simultaneously, or nearly simultaneously, interrupt or otherwise introduce a stamp or other indicator into a signal generated by one or more of, for example, fetal-oximetry sensor 115, Doppler / ultrasound sensor 135, pulse oximetry sensor 130, Vis-NIRS adult hemoglobin sensor 125, uterine contraction measurement device 140, ECG measurement device 175, and / or ventilatory / respiratory signal source 195.[000108] FIG. 1 B is a block diagram of an exemplary set of components that may be included in a transabdominal-fetal-oximetry sensor 115A, such as the transabdominal-fetal-oximetry sensors disclosed herein. Transabdominal-fetal-oximetry sensor 115A may be configured to, for example, project light into a pregnant mammal’s abdomen and detect a resultant (via, for example, reflection and / or back scattering) optical signal. This resultant optical signal may be analyzed to, for example, determine fetal-oximetry information. Transabdominal-fetal-oximetry sensor 115A may include a port(s) 141, a transceiver 142, a power supply 146, one or more light source(s) 105, a uterine contraction measurement device 148, a controller, processor, and / or memory 172, one or more detectors 160, a signal processing component 154, a calibration component 156, and / or a user interface 64.[000109] Light source(s) 105 may be configured to emit light of various intensities and / or of various wavelengths (e.g., red and / or infrared). In some embodiments, one or more light source(s) may be tunable and / or adjustable to, for example, facilitate emission of light with desired characteristics. Detector(s) 160 may be any device configured to detect an optical signal and / or photon and communicate same to, for example, computer and / or processor 150, controller, processor, and / or memory 172, transceiver 142, and / or an external device. In some instances, detector 160 may be configured to convert the detected optical signal / photon into a current, voltage, and / or electronic signal.[000110] Controller, processor, and / or memory 172 may be communicatively coupled to one or more components of transabdominal-fetal-oximetry sensor 115A. For example, controller, processor, and / or memory 172 may be communicatively coupled to detector(s) 160 and may be configured to receive one or more voltage readings, detected electronic signal(s), and / or composite signals therefrom. Controller, processor, and / or memory 172 may also be communicatively coupled to light source 105 and may be configured to provide instructions thereto. Exemplaryinstructions include, but are not limited to, turning light source 105 on / off, a duration of time to project light, light modulation instructions, and / or what type (e.g., wavelength or set of wavelengths) and / or intensity of light to emit.[000111] In some embodiments, controller, processor, and / or memory 172 may be configured to pre-process and / or filter signals received from one or more detectors 160. Exemplary pre-processing includes, but is not limited to, filtering (e.g., bandpass or Kalman filter), synchronous detection / demodulation, and / or noise reduction / cancellation. One or more operations performed by controller, processor, and / or memory 172 may be executed using one or more sets of instructions stored thereon and / or received via, for example, port(s) 141 and / or transceiver 142. At times, these instructions may be updated via communications received via, for example, port(s) 141, user interface 164, and / or transceiver 142. In addition, controller, processor, and / or memory 172 may be configured to store and / or execute instructions for one or more processes, or process steps, disclosed herein.[000112] Transceiver 142 may be communicatively coupled to components of transabdominal-fetal-oximetry sensor 115A and / or devices external thereto (e.g., a computer, processor, external equipment or a display devices). In some instances, controller, processor, and / or memory 172, power supply 146, and / or port(s) 141 and may be configured to communicate composite signals, analog signals, optical signals, and / or detected electronic signals to one or more communicatively connected devices such as receiver / interface 145 and / or display device 155. Transceiver 142 may also be configured to receive instructions regarding the operation of transabdominal-fetal-oximetry sensor 115A and provide these instructions to computer and / or processor 150. Transceiver 142 may be configured to operate via wired and / or wireless communications.[000113] Uterine contraction measurement device 148 may be a device configured to measure, for example, an intensity, time, and / or duration of uterine contractions. Exemplary uterine contraction measurement devices 148 include, but are not limited to, pressure transducers, force sensors, piezo-resistance elements, piezo-electrical elements, strain gauges, EMG devices, force meters, and / or intrauterine pressure catheters or components thereof.[000114] Power supply 146 may be any power supply configured to provide electrical power to one or more components of transabdominal-fetal-oximetry sensor 115A. In some embodiments, power supply 146 may be a battery (rechargeable orotherwise). Additionally, or alternatively, power supply may be and / or include a coupling to an AC power supply (e.g., wall outlet). Port(s) 141 may be configured to, for example, provide power to and / or act as a communications interface for transabdominal-fetal-oximetry sensor 115A. Exemplary ports 141 include, but are not limited to USB ports, ethernet ports and the like. In some instances, port(s) 141 may include two or more ports.[000115] Signal processing component 154 may be configured to, for example, improve SNR, adjust gain for a detected electronic signal, filter a detected electronic signal, and / or amplify components of a detected electronic signal. Calibration component 156 may be configured to, for example, calibrate light source(s) 105 and / or detector(s) 160.[000116] User interface 164 may be one or more components configured to receive input (e.g., instructions, patient data, etc.) from a user and / or provide information (e.g., error messages, fetal-oximetry information, confirmation of correct placement, etc.) to the user. Exemplary user interfaces 164 include, but are not limited to, screens, keyboards, buttons, and dials.[000117] FIG. 1C is a block diagram of exemplary fetal sensor 115A positioned on a pregnant mammal’s abdomen. The maternal tissue of the pregnant mammal’s abdomen is represented as an abstraction of maternal tissue 214 and a fetus within the pregnant mammal’s abdomen is represented as an abstraction of a fetus 280.[000118] Fetal sensor 115a has one light source 105 and six detectors 160A, 160B, 160C, 160D, 160E, and 160F, each of which have a different position relative to light source 105 with first detector 160A being the closest to source 105 and sixth detector 160F being the furthest away from source 105. A position of a detector 160A-160F relative to source 105 may be referred to herein as a source / detector distance. In some embodiments, detectors 160A-160F may be arranged linearly and may be positioned 0.5-3cm apart from one another. For example, if detectors 160A-160F are 2cm apart, first detector 160A may be positioned 2cm away from source 105, second detector 160B may be positioned 2cm away from first detector 160A, third detector 160C may be positioned 2cm away from second detector 160B, fourth detector 160D may be positioned 2cm away from third detector 160C, fifth detector 160E may be positioned 2cm away from fourth detector 160D, and sixth detector 160F may be positioned 2cm away from fifth detector 160E but this need not always be the case. In some embodiments, a sensor like fetal sensor 115A may have fewer(e.g., 1-5) than six detectors. For example, in some embodiments, fetal sensor 115A may have two or four detectors 160[000119] During use, source 105 may project an optical signal 190 into the pregnant mammal’s abdomen 206 and a resultant optical signal may be detected by one or more of detector(s) 160A-160F. It is expected that the detectors positioned closer to source 105 will detect a portion of the optical signal that has been incident on the pregnant mammal’s abdomen 206 but not fetus 280 and, in some embodiments, first detector 160A and / or second detector 160B may be positioned via, for example, setting of a source / detector distance, so that a majority, if not all, of an optical signal 190A and 190B detected by first and second detectors 160A and 160B, respectively, has only been incident on the pregnant mammal’s abdomen 206 (i.e., is not incident on the fetus). Third-sixth detectors 160C-160F may detect portions of the optical signal 190C, 190D, 190E, and 190F that are incident on the pregnant mammal 214 and fetus 280 as shown in FIG. 1C. In some cases, third detector 160C may be positioned 3-5cm away from the light source and sixth detector 160F may be positioned 6-10cm away from the light source. Additionally, or alternatively, third-sixth detectors 160C-160F may be positioned within 4-10cm of the light source.[000120] As the source / detector distance increases a proportion of the optical signal that corresponds to light that was incident on fetus 280 increases. Thus, optical signal 190F may include a higher proportion of light that was incident on the fetus (as opposed to the pregnant mammal) than, for example, optical signal 190E or 190D.[000121] FIG. 1D is a block diagram of exemplary components of a direct-measurement-fetal-oximetry sensor 115B configured to be placed on, or proximate to, fetal skin (prior to delivery), often times without intervening layers of maternal tissue. Direct-measurement-fetal-oximetry sensor 115B includes many of the same components of transabdominal-fetal-oximetry sensor 115A and also optionally includes one or more ECG lead(s) 144, a temperature sensor 152, a contact sensor 158 configured to sense contact with fetal and / or maternal tissue, a force / pressure sensor 162, a colorimeter 166, a camera 168, and an accelerometer 169.[000122] ECG lead(s) 144 may be one or more leads and / or sensors configured to detect impedance and / or an electrical signal and / or electrical potential generated by a fetus’ heart and / or detect an electrical current of the fetus. ECG lead 144 may beconfigured to provide feedback regarding whether or not direct-measurement-fetal-oximetry sensor 115B is in contact with fetal skin because when direct-measurement-fetal-oximetry sensor 115B is decoupled from fetal skin (i.e., an ECG lead 144 is not in contact with fetal skin and is potentially floating in the amniotic fluid) a low impedance path may exist between two ECG leads that is different from the impedance measured between these two leads when the lead is in contact with the fetal skin. This impedance difference can be measured using, for example, ECG leadoff detection circuitry and / or bioimpedance measurement circuitry. In some embodiments, one or more ECG lead(s) 144 may be positioned so that they are in contact with the fetus and additional ECG lead(s) 144 may be positioned so that they may be in contact with, for example, maternal tissue (e.g., skin (e.g., thigh), vaginal wall, and / or uterine wall when direct-measurement-fetal-oximetry sensor is in situ within the pregnant mammal’s body / uterus.[000123] On some occasions, indications of fetal heartrate and / or cardiac activity provided by ECG lead(s) 144 may be a significant improvement (e.g., more accurate) over the current standard of care, which is to measure fetal heartrate via an ultrasound and / or Doppler machine at least because it is a more direct (i.e., in direct contact) signal than the standard ultrasound method, which relies on measuring fetal heartrate by transmitting an acoustic signal through the maternal abdomen to reach the fetus and then analyzing a reflected ultrasonic signal. Additionally, or alternatively, indications of fetal heartrate and / or cardiac activity provided by ECG lead(s) 144 may be a significant improvement over the current standard of care because ECG waveforms (provided by ECG lead(s) 144) may be easier to process than the Doppler signals based upon waveform morphology (e.g., the R-waves are fairly easy to detect in an ECG waveform with good time resolution).[000124] The improved accuracy provided by use of fetal ECG measurements recorded via ECG lead(s) 144 may correspondingly improve analysis of an optical signal detected by detector(s) 160 to determine fetal-oximetry information as disclosed herein.[000125] Force / pressure sensor 162 may be configured to sense pressure and / or force applied to direct-measurement-fetal-oximetry sensor 115B, or a component thereof. Exemplary force / pressure sensors 162 include force meters (e.g., a strain gauge), force sensitive resistors, and a spring-based pressure switch that may be configured to activate when a minimum magnitude of force is applied. Additionally, oralternatively, force / pressure sensor 162 may be configured to measure pressure within an amniotic space inside the pregnant mammal’s uterus, using, for example, an intrauterine pressure catheter (IUPC). The force / pressure may be applied by a uterus of the pregnant mammal and a force / pressure reading may be used to determine whether or not direct-measurement-fetal-oximetry sensor 115B is pressed up against the fetal skin and / or wedged between the fetal skin and internal uterine wall because, for example, when direct-measurement-fetal-oximetry sensor 115B is floating in amniotic fluid (i.e., not in direct contact with fetal skin) there may be no, or a reduced amount, of pressure exerted thereon. In some embodiments, force / pressure sensor 162 may be configured to determine characteristics of uterine tone (contraction, relaxation, etc.). Additionally, or alternatively, force / pressure sensor 162 may be embodied as a pressure sensor for an inflation line (e.g., inflation line 215 shown in FIGs. 2A and 2B and discussed below) communicatively coupled to a stabilization device (e.g., stabilization device 225, shown in FIG. 2B and discussed below).[000126] Temperature sensor 152 may be configured to measure a temperature of adjacent tissue (e.g., cervix, vaginal wall, fetus), which may be useful in monitoring the pregnant mammal’s and / or fetus’ health and / or body temperature and, in particular, may be used to monitor for infections like chorioamnionitis or endometritis. Camera 168 may be embodied as a camera and / or an optical instrument (e.g., a fiber optic cable) configured to enable visual observation (e.g., photographs, video, color measurements, etc.) of the fetus and / or direct-measurement-fetal-oximetry sensor 115B while in situ and / or while being placed in situ. In some embodiments, information provided by camera 168 may be used to, for example, confirm a position and / or orientation of measurement-fetal-oximetry sensor 115B (e.g., on fetal skin, on uterine tissue, on cervical tissue, floating in amniotic fluid, etc.), determine if meconium is present within the pregnant mammal’s uterus, and / or obtain skin pigmentation and / or colorimetry (e.g., skin tone) information for the fetus. Additionally, or alternatively, skin tone and / or color may be provided by colorimeter 166.[000127] Accelerometer 169 may be configured to detect and / or measure motion, acceleration, and / or changes in orientation of the fetus and / or surrounding tissue (e.g., uterus). These measurements may be used to, for example, detect and / or cancel motion artifacts in one or more signals (e.g., an optical signal) provided by direct-measurement-fetal-oximetry sensor 115B.[000128] FIG. 2A is a top plan view of an exemplary direct-measurement-fetal-oximetry sensor 200, 201, or 202 and FIG. 2B is a side plan view of an exemplary direct-measurement-fetal-oximetry sensor 200 with a positioning extension 210. Direct-measurement-fetal-oximetry sensor 200 includes a housing 205 sized, shaped, and configured to house one or more components of direct-measurement-fetal-oximetry sensor 115B. As used herein, “housing 205” may refer to any and / or all of the direct-measurement-fetal-oximetry housings disclosed herein including, but not limited to housing 205A, housing 205B, housing 205C, housing 205D, and / or housing 205E. In some embodiments, housing 205 may include one or more optional markers 207 that may be configured, positioned, and / or sized to be easily observable using an imaging technology. For example, marker 207 may be sonically and / or radio opaque so that it clearly shows up in an ultrasound and / or X-ray image, respectively. In some embodiments, marker 207 may be used to determine a fetal depth (e.g., a distance between a fetal and maternal epidermis). In these embodiments, an imaging technology like ultrasound may be used to find marker 207 when in position and a distance between marker 207 and the maternal epidermis may be determined using the ultrasound image and, for example, measuring a distance between marker 207 and the maternal epidermis as shown in one or more ultrasound images.[000129] Additionally, or alternatively, housing 205 and / or a surface thereof including a light source 105 and one or more detectors 160 may have one or more mechanisms or optically-isolating features (e.g., blinders, extensions, recesses, opaque materials, gaskets, etc.) configured to limit or eliminate optical shunting between one or more light source(s) 105 and one or more detector(s) 160. For example, FIG. 2A1A provides a schematic diagram of a top view and FIG. 2A1B provides a schematic diagram of a cross-section view of a first housing 205A with a first front, or active, surface 230A that includes four detectors 160 optically separated from light source 105 by an optically-isolating feature embodied as a raised rib 282 that stands proud of a surface of first housing 205A (as may be seen in FIG. 2A1B). Raised rib 282 may be configured to optically isolate detector(s) 160 from light directly emitted by light source 105, thereby preventing optical shunting between them.[000130] Additionally, or alternatively, a housing 205 may include an optically-isolating flange or boarder like those of FIGs. 2A2A and 2A2B; wherein FIG. 2A2A provides a schematic diagram of a top view and FIG. 2A2B provides a schematic diagram of a cross-section view of a second housing 205B with a second front, oractive, surface 230B that includes four detectors 160 optically separated from light source 105 by an optically-isolating feature embodied as a raised boarder or flange 284 that surrounds light source 105 (as may be seen in FIG. 2A2A) and stands proud of a surface of second housing 205B as may be seen in FIG. 2A2B. Raised boarder or flange 284 may be configured to optically isolate detector(s) 160 from light directly emitted by light source 105, thereby preventing optical shunting between them. When embodied as a flange, raised boarder or flange 284 may be configured to flare out upon contact with fetal skin in a manner similar to, for example, a suction cup.[000131] Additionally, or alternatively, a housing 205 may include an optically-isolating flange or border like those of FIGs. 2A3A and 2A3B; wherein FIG. 2A3A provides a schematic diagram of a top view and FIG. 2A3B provides a schematic diagram of a cross-section view of a third housing 205C with a third front, or active, surface 230B that includes four detectors 160 optically separated from light source 105 by an optically-isolating feature embodied as a raised boarder or flange 286 that surrounds all four detectors 160 (as may be seen in FIG. 2A3A) and stands proud of a surface of third housing 205B as may be seen in FIG. 2A3B. Raised boarder or flange 246 may be configured to optically isolate detector(s) 160 from light directly emitted by light source 105, thereby preventing optical shunting between them. When embodied as a flange, raised boarder or flange 286 may be configured to flare out upon contact with fetal skin in a manner similar to, for example, a suction cup.[000132] Additionally, or alternatively, a housing 205 may include one or more components that sit proud of an active surface thereof. For example, FIG. 2A4 provides a side view of a fourth housing 205D with a fourth active surface 230D that includes four detectors 160 that sit proud (e.g., 0.5-5mm) of the surface, or exterior, of fourth housing 205D and a light source 105 that sits flush with the exterior surface of fourth housing 205D as shown in the figure. In this embodiment, detectors 160 may be pressed into the fetal skin slightly when the exterior of fourth housing 205D abuts (e.g., is pressed into) the fetal skin and the fetal skin positioned between the proudly placed detectors 160 may act to optically isolate them from source 105.[000133] Additionally, or alternatively, a housing 205 may include a light source 105 that is recessed into the active surface 230 thereof. For example, FIG. 2A5 provides a side, or cut-away, view of a fifth housing 205E with a fifth active surface 230E that includes four detectors 160 that sit proud (e.g., 0.5-5mm above) of the surface, or exterior, of fifth housing 205E and a light source 105 that sits within arecess, or cavity, 288 as shown in the figure. Cavity 288 may be configured to reduce the angular cone of the source illumination and detector light captures. Optionally, an exterior surface of cavity 288 may be coated with and / or comprise a light-absorbing material. Additionally, or alternatively, cavity 288 may be covered with and / or include an aperture and / or one or more lenses configured to reduce the angular cone of the source illumination and detector light captures. In this embodiment, detectors 160 may be pressed into the fetal skin slightly when the exterior surface of fourth housing 205D abuts (e.g., is pressed into) the fetal skin and the fetal skin positioned between the proudly placed detectors 160 may act to optically isolate them from source 105 and light from source 105 may not travel across active surface 230E.[000134] Additionally, or alternatively, a housing 205 may include a light source 105 that is proud of, and / or a plurality of detectors that are flush with active surface 230 thereof. For example, FIG. 2A6 provides a side, or cut-away, view of a fifth housing 205F with a sixth active surface 230F that includes four detectors 160 that flush with active surface 230F and a light source 105 that sits proud e.g., 0.5-5mm above) of sixth active surface 230F. In this embodiment, light source 105 may be configured and arranged within active surface 230F so that it presses into fetal skin during operation and the fetal skin may act to limit optical shunting between detectors 160 and light source 105 by, for example, limiting a direct pathway (e.g., an optical pipeline) between them.[000135] Additionally, or alternatively, a housing 205 may include a one or more detectors that are recessed into the active surface 230 thereof. For example, FIG. 2A7 provides a side, or cut-away, view of a seventh housing 205F with a seventh active surface 230F that includes four detectors 160, each of which are positioned within a recess, or cavity, 298 and a light source 105 that sits proud (e.g., 0.5-5mm above) of the surface, or exterior, of seventh housing 205F as shown in the figure. Cavity 298 may be configured to reduce optical shunting between light source 105 and their respective detector 160 by eliminating a direct pathway for light to travel between the light source 105 and each detector 160. Optionally, an exterior surface of cavity 298 may be coated with and / or comprise a light-reflecting material. In this embodiment, light source 105 may be configured and arranged within active surface 230G so that it presses into fetal skin during operation and the fetal skin may act to limit optical shunting between detectors 160 and light source 105 by, for example, limiting a direct pathway (e.g., an optical pipeline) between them.[000136] FIG. 2A8 provides a side, or cut-away, view of an eighth housing 205H with an eighth active surface 230H that includes four detectors 160, all of which are positioned within a single recess, or cavity, 299 and a light source 105 that sits proud (e.g., 0.5-5mm above) of the surface, or exterior, of seventh housing 205F as shown in the figure. Cavity 299 may be configured to reduce optical shunting between light source 105 and detectors 160 by eliminating a direct pathway for light to travel between the light source 105 and the detectors 160. Optionally, an exterior surface of cavity 299 may be coated with and / or comprise a light-reflecting material. In this embodiment, light source 105 may be configured and arranged within active surface 230H so that it presses into fetal skin during operation and the fetal skin may act to limit optical shunting between detectors 160 and light source 105 by, for example, limiting a direct pathway (e.g., an optical pipeline) between them.[000137] In some embodiments, two or more optically-isolating features like those shown in FIGs. 2A1A, 2A2A, 2A3A, 2A4, 2A5, 2A6, 2A7 and / or 2A8 may be used in combination. For example, raised rib 282 may be incorporated into a housing like second, third, fourth, and / or fifth housings 205B, 205C, 205D, and / or 205E to further optically isolate one or more of the detectors from light emitted by light source 105. In another example, light source 105 may be positioned within a recess like recess 288 of first, second, third, and / or fourth housings 205B, 205C, and / or 205D.[000138] In some embodiments, direct-measurement-fetal-oximetry sensor 200 may be configured to project one or more additional wavelengths of light (e.g., wavelengths not used to obtain fetal oximetry information (e.g., red and / or near infrared light)) to, for example, perform contact sensing and / or provide information and / or feedback regarding whether the fetal oximetry sensor and / or components thereof are in contact with fetal skin. This may be achieved via, for example, one or more light sources configured to emit light attenuated by fetal skin green light (e.g., light with a wavelength of 495-570nm and / or light with a wavelength that matches an isosbestic point of fetal skin. Detection of these additional wavelengths may be a proxy for optical shunting of the oximetry wavelengths emitted by source 160 because they may be very highly attenuated and / or absorbed by the tissue so, if they are detected by detector 160, it is likely a result of optical shunting, which is an indication that the direct-measurement-fetal-oximetry sensor 200 is not in contact with fetal skin. Additionally, or alternatively, analysis of the one or more additional wavelengths oflight may be used to provide a plethysmograph signal that is more accurate / reliable and / or as a trigger for averaging / qualifying red / NIR signals.[000139] FIGs. 2A9-2A11 provide three different examples of direct-measurement-fetal-oximetry sensors 200 that include one or more contact-sensing light sources 236 configured to provide and / or generate a signal that may be used to verify contact of the respective sensor (or components thereof) with fetal skin, trigger averaging and / or qualifying red and / or near infra-red (NIR) signals, and / or enhance fetal heart rate reporting. A distance between one or more contact-sensing light sources 236 may be adjusted and / or optimized to, for example, enhance and / or increase shunt discrimination and / or signal resolution. In particular, FIG. 2A9 is a block diagram of a direct-measurement-fetal-oximetry sensor 200 with a ninth housing 205I that houses a light source 105 configured to emit light that may be used to obtain fetal oximetry information (e.g., light of red and / or infrared wavelengths), a contact-sensing light source 236 configured to emit light that is highly attenuated by fetal tissue (e.g., light of a green wavelength), and a detector 160 configured and arranged to detect light from light source 105 and / or contact-sensing light source 236 that is reflected and / or backscattered from fetal tissue. A distance, pi, between light source 105 and detector 160 may be approximately 9-20mm, 11-17mm, 13-15mm, or 14mm. A distance, p2, between contact-sensing light source 236 and detector 160 may be approximately 1.5mm, 2mm, or 1mm and / or may be a portion, or fraction, (e.g., 1 / 9, 1 / 5, or 1 / 10) of pi.[000140] FIG. 2A10 is a block diagram of a direct-measurement-fetal-oximetry sensor 200 with a tenth housing 205J that houses light source 105, a first contact-sensing light source 236A, a second contact-sensing light source 236B, and a detector 160 configured and arranged to detect light from light source 105, first, and / or second contact-sensing light source 236A and / or 236B that is reflected and / or backscattered from fetal tissue. First and second contact-sensing light sources 236A and 236B are arranged on an approximately linear and horizontal fashion on the left and right (as oriented in FIG. 2A10) of detector 160 as shown at a distance of p2A and P2B, respectively. In some embodiments, a magnitude and / or direction of p2, P2A, and P2B may be the same, or approximately the same. In other embodiments, a magnitude and / or direction of p2, P2A, may be different from p2B.[000141] FIG. 2A11 is a block diagram of a direct-measurement-fetal-oximetry sensor 200 with a housing 205K that houses light source 105, first contact-sensing light source 236A, second contact-sensing light source 236B, a third contact-sensing light source 236C, a fourth contact-sensing light source 236D, and a detector 160 configured and arranged to detect light from light source 105, first, second, third, and / or fourth contact-sensing light source 236A, 236B, 236C, and / or 236D that is reflected and / or backscattered from fetal tissue. Third and fourth contact-sensing light sources 236C and 236D are arranged on an approximately linear and vertical fashion on the top and bottom (as oriented in FIG. 2A11) of detector 160 as shown at a distance of p2c and p2D, respectively. In some embodiments, a magnitude of p2, P2A, P2B, P2c, and p2D may be the same, or approximately the same. In other embodiments, one or more of the magnitudes for p2, P2A, P2B, P2c, and p2D may be different from one another.[000142] At times, for the sake of brevity, first, second, third, fourth, and / or fifth housings 205A, 205B, 205C, 205D, and / or 205E may be collectively referred to as “housing 205” herein. Housing 205 may be physically coupled (e.g., bonded, affixed, and / or joined) to positioning extension 210. In some cases, a joint between housing 205 and positioning extension 225 may be configured to articulate to, for example, enable insertion and / or proper positioning of housing 205 on fetal skin. Positioning extension 210 may include a cord 220 configured to, for example, provide electricity to direct-measurement-fetal-oximetry sensor 115B and / or enable communication of, for example, light source drive signals, raw detector signals, ECG signals, temperature signals, force, and / or pressure signals between one or more components of direct-measurement-fetal-oximetry sensor 115B and an external device (e.g., a computer and / or display device). Optionally, positioning extension 210 may include a reference electrode 244 configured to be in electrical contact with maternal tissue (e.g., vaginal or uterine tissue). In some instances, cord 220 may be used to extract direct-measurement-fetal-oximetry sensor 200 from a subject’s uterus and / or body.[000143] In some embodiments, positioning extension 210 may also include an inflation line 215 with a lumen therein configured to provide inflating fluid (e.g., saline) or gas (e.g., air) to an optional inflatable stabilization device 225 (as seen in FIG. 2B). Stabilization device 225 may be configured to be positioned between fetal skin and an internal uterine wall and may be inflated and / or adjusted to occupy spacetherebetween to press a front, or active, surface 230 of direct-measurement-fetal-oximetry sensor 200 and / or housing 205 against the fetal skin and / or assist with maintaining contact between the fetal skin. In some embodiments, a degree to which stabilization device 225 is inflated may be responsive to, for example, a degree of back pressure and / or force exerted on the inflation line (as measured by, for example, a pressure and / or force gauge), a degree of pressure and / or force required to further inflate stabilization device 225, and / or a measurement taken from one or more components of direct-measurement-fetal-oximetry sensor 115B. For example, if an ECG lead 144 and / or contact sensor 158 is no longer responding and / or provides a measurement indicating that contact with fetal skin has been lost and / or a measurement provided by force / pressure sensor 162 indicates that contact with fetal skin has been lost, a message communicating same and / or an instruction to further inflate stabilization device 225 may be communicated (via, e.g., transceiver 142 and / or cord 220) to a device providing the inflating gas and / or liquid.[000144] In some embodiments, a degree of inflation of stabilization device 225 may be responsive to a position of the fetus within the uterus and / or birth canal and may be configured to, for example, deflate as, for example, a labor and delivery process of the fetus transitions from the first to the second stage of labor. Deflation of stabilization device 225 in this manner may assist with reducing an overall size / profile of direct-measurement-fetal-oximetry sensor 200 so that, for example, it does not interfere with the movement of the fetus through the birth canal. In some embodiments, a level of inflation of stabilization device 225 may vary over time (e.g., may periodically inflate and / or deflate) which may assist with labor and delivery of the fetus and / or prevent dystocia.[000145] Additionally, or alternatively, in some embodiments, a degree of inflation of stabilization device 225 may be responsive to uterine contractions as measured by, for example, uterine contraction measurement device 148 and / or force / pressure sensor 162. In these embodiments, stabilization device 225 may be configured to deflate as the uterus contracts and may inflate as the uterus relaxes to, for example, fill a space between the uterine wall and fetal skin. In this way, contact of direct-measurement-fetal-oximetry sensor 200 and / or housing 205 with fetal skin may be maintained through fluctuations of uterine contractions over time.[000146] In some embodiments, stabilization device 225 may be configured to expand and / or fill space until an external pressure is exerted thereon. In theseembodiments, stabilization device 225 may comprise a material (e.g., foam) configured to expand upon contact with water or amniotic fluid and fill a space between fetal skin and an inner uterine wall. Additionally, or alternatively, stabilization device 225 may comprise a deformable material (e.g., gel and / or memory foam) configured to deform and / or mold to fill a space between fetal skin and an inner uterine wall.[000147] In some embodiments, a surface of an outer surface 240 of direct-measurement-fetal-oximetry sensor 200 may be coated and / or treated with a lubricious coating to, for example, facilitate movement of outer surface 240 along an interior wall of the uterus, cervix, and / or vagina as the fetus is pushed out of the uterus. Additionally, or alternatively, active surface 230 may be manufactured to have a friction-inducing surface that, for example, assists with holding active surface 230 against the fetal skin and / or prevents sliding or movement of active surface 230 when positioned on the fetal skin.[000148] In many embodiments, direct-measurement-fetal-oximetry sensor 200 may be configured so that light source(s) 105 and / or detector(s) 160 are positioned proximate to and / or abut active surface 230 and all, or a portion of, active surface 230 is transparent, or semi-transparent, so that light emitted by light source(s) 105 may pass through active surface 230 into the fetal skin and backscattered light may be detected by detector(s) 160.[000149] FIG. 2C is a schematic diagram of a side view of another exemplary direct-measurement-fetal-oximetry sensor 201, which is similar to direct-measurement-fetal-oximetry sensor 200 with except that it does not include inflation line 215 and stabilizing device 225 and, instead includes a curved extension 270 sized, shaped, and configured to assist with the positioning and / or maintaining a position of direct-measurement-fetal-oximetry sensor 201, and / or active side 230, against fetal skin by, for example, exerting a force on the uterine wall that acts to push active surface 230 in the opposite direction (i.e., toward fetal skin) and, in this way, may help with keeping active surface 230 correctly in contact with fetal skin. In some embodiments, curved extension 270 may be flexible and / or configured to apply a controlled range of force the uterine wall, which is translated into pressing into the fetal skin and / or fetal cheek.[000150] FIG. 2D is a schematic diagram of a side view of another exemplary direct-measurement-fetal-oximetry sensor 202, which is similar to direct-measurement-fetal-oximetry sensor 201 with except that it does not include curvedextension 270 and instead includes an extension 275 that sits proud from a back (i.e., side opposite to active side 230) side of housing 205. Extension 275 may be any shape (e.g., rectangle, square, circle, oval, etc.) and may be made from any appropriate material including, but not limited to, silicone, foam, memory foam, plastic, and, on some occasions, may be deformable via, for example, a membrane enclosing a fluid (e.g., air, saline, gel, etc.). Extension 275 may be sized, shaped, and configured to assist with the positioning and / or maintaining a position of direct-measurement-fetal-oximetry sensor 202, and / or active side 230, against fetal skin by, for example, exerting a force on the uterine wall that acts to push active surface 230 in the opposite direction (i.e., toward fetal skin) and, in this way, may help with keeping active surface 230 correctly in contact with fetal skin. In some embodiments, extension 275 may be flexible, compressible, and / or configured to adapt to a shape of the uterus, adapt to a shape between the fetus and uterine wall, and / or apply a controlled range of force the uterine wall, which is translated into pressing into the fetal skin and / or fetal cheek.[000151] FIG. 2E is a schematic diagram of a side view of a further example of a direct-measurement-fetal-oximetry configured to detect fetal and maternal tissue optical property information. Direct-measurement-fetal-oximetry sensor 204 includes a housing 205 with active side 230 that may be configured as one or more of the active sides 230 disclosed herein. Direct-measurement-fetal-oximetry sensor 204 also includes a maternal optical sensor side 232 that provides / houses a set of a set of maternal optical and / or oximetry sensors. The set of maternal optical and / or oximetry sensors may include a light source 105 and one or more detector(s) 160 (in the case of FIG. 2E, there are two detectors 160 but, this need not always be the case) and may be sized, configured, and / or positioned to project light into maternal tissue (e.g., uterus and other abdominal tissue (e.g., adipose and skin) and receive light backscattered by the maternal tissue, which may be sent to, for example, a processor and / or computer (e.g., computer and / or processor) and used by the processor and / or computer to determine maternal tissue optical property information (e.g., tissue oxygen saturation) or other optical characteristics (e.g., scattering and / or absorption) of the maternal tissue positioned between direct-measurement-fetal-oximetry sensor 204 and a fetus within the pregnant mammal’s abdomen. In some embodiments, a side of housing 205 including the set of maternal optical sensors may also include one or more contact sensors, contact electrodes, and / or pressure sensors to provideinformation that may be used to determine whether housing 205 and the set of maternal optical sensors are in adequate contact with maternal tissue.[000152] FIG. 3A provides a schematic diagram of a top plan view of a first exemplary system 301 that includes a first fetal ECG measurement device 175A and an optional external reference electrode 385 that may be put in contact with non-fetal tissue such as a vaginal canal or maternal leg. First fetal ECG measurement device 175A includes a positioning extension 310 that houses an optional inflation line 315, an optional marker 339, and a cord, or wire, 320 configured to, for example, provide electricity to first ECG measurement device 175A and / or enable communication of, for example, ECG signals received by an ECG lead 350 to computer and / or processor 150. First fetal ECG measurement device 175A also includes a first housing 305A sized, shaped, and configured to house ECG lead 350, and required circuitry for its operation and communication with system 100 and / or components thereof such as a communicative coupling between ECG lead 350 and wire 320. In some embodiments, positioning extension 310 may include an internal reference electrode 380 positioned and configured to contact and / or electrically couple to maternal tissue such as the uterus, cervix, and / or vagina. In some embodiments, data from first fetal ECG measurement device 175A may be used with data from internal reference electrode 380 and / or an optional external reference electrode 385 to, for example, perform one or more methods disclosed herein.[000153] Optionally, first exemplary system 301 and / or first housing 305A may include a fetal temperature sensor 335 configured to sense a temperature of the fetus and / or uterus while first housing 305A is in situ proximate to fetal skin. Additionally, or alternatively, first fetal ECG measurement device 175A (e.g., positioning extension 310) may include a maternal temperature sensor 337 configured to sense a temperature of maternal tissue (e.g., the cervix and / or vagina) while, for example, positioning extension 310 is positioned therein and / or first housing 305A is in situ proximate to fetal skin. Additionally, or alternatively, first fetal ECG measurement device 175A and / or first housing 305A may include an optional marker 339 configured to, for example, be opaque when one or more imaging technologies are used to image the fetal and / or maternal tissue. For example, marker 339 may be echogenically and / or radio opaque so that it is easily visualized when, for example, a pregnant mammal’s abdomen and / or the fetus is imaged using, for example, ultrasound and / or other imaging technology. Thus, marker 339 may be configured to assist clinicianswith visualization of a position of first housing 305A and / or first fetal ECG measurement device 175A relative to maternal and / or fetal anatomy during use.[000154] Additionally, or alternatively, first fetal ECG measurement device 175A may include one or more optional engagement feature(s) 352 configured to increase friction and / or grippiness between first housing 305A and the fetal skin. Engagement feature(s) 352 may include, for example, a rubber or silicone feature that has an approximately uniform smooth surface, an approximately uniform rough surface, and / or a plurality of features (e.g., ridges, nubs, and / or divots) configured to removably engage with fetal skin and increase a coefficient of friction between the fetal skin and first housing 305A, thereby decreasing a likelihood that first housing 305A will slip off, or otherwise disengage from, the fetal skin. The features of engagement feature(s) 352 may be arranged in any pattern (e.g., dots, stripes, zig-zags, curved lines, etc.). Although engagement feature(s) 352 are shown to surround an exterior of first housing 305A, this need not always be the case. For example, in some embodiments, one or more engagement feature(s) 352 may be positioned on a surface of first housing 305A including ECG lead 350 and / or another (e.g., back or side) surface of first housing 305A and / or positioning extension 310.[000155] FIG. 3B1 provides a schematic diagram of a top plan view of a second exemplary fetal ECG measurement device 175B that includes positioning extension 310, optional inflation line 315, cord 320, optional engagement feature(s) 352, and optional maternal temperature sensor 337. Second fetal ECG measurement device 175B also includes a second housing 305B sized, shaped, and configured to house a first ECG lead 350A, a second ECG lead 350B, optional fetal temperature sensor 335, optional marker 339, and circuitry used for operation of second exemplary fetal ECG measurement device 175B and communication with system 100 and / or components thereof (e.g., communicative and / or electrical couplings between first and second ECG leads 350A, 350B, and optional temperature sensor and cord 320).[000156] Second housing 305B also includes a first optional non-conductive, electrically-isolating element 340A (also referred to herein as “first electrically-isolating element 340A”) sized, configured, and positioned to surround first ECG lead 350A and electrically isolate it from second ECG lead 350B and a second optional non-conductive, electrically-isolating, element 340B (also referred to herein as “second electrically-isolating element 340B”) sized, configured, and positioned to surround second ECG lead 350B and electrically isolate it from first ECG lead 350A. First and / orsecond optional electrically-isolating element(s) 340A and / or 340B may be embodied as a raised projection that extends above (e.g., 0.1 -5mm) a surface of first and / or second ECG lead(s) 350A and / or 350B that acts to contain any fluid (e.g., amniotic fluid) surrounding their respective ECG leads so that the first and second ECG leads 350A and 350B and fluid proximate thereto are electrically isolated from one another, thereby preventing electrical communication between first and second ECG leads 350A and 350B via, for example, amniotic fluid. In some embodiments, second fetal ECG measurement device 175B may include only first or second electrically-isolating element 340A or 340B. For example, first electrically-isolating element 340A may electrically insulate ECG lead 350A from ECG lead 350B without second electrically-isolating element 340B.[000157] FIG. 3B2 provides a schematic diagram of a cross section (taken along line 3B2-3B2 of FIG. 3B1) of second exemplary fetal ECG measurement device 175B when positioned in utero proximate to fetal skin. As may be seen in FIG. 3B2, when second exemplary fetal ECG measurement device 175B is positioned proximate to fetal skin 292 in utero, first electrically-isolating element 340A may contact fetal skin 292 and electrically isolate a volume of amniotic fluid 394 from a surrounding, ambient, volume of amniotic fluid that may, or may not, be in electrical contact with second ECG lead 350B. Optional second electrically-isolating element 340B may be configured to operate in a manner similar to that of first electrically-isolating element 340A shown in, for example, FIG. 3B2.[000158] FIG. 3C provides a schematic diagram of a top plan view of a third exemplary fetal ECG measurement device 175C that includes all the components of second fetal ECG measurement device 175B as well as a third ECG lead 350C and a third optional electrically-isolating element 340C sized, configured, and positioned to surround third ECG lead 350C and electrically isolate it from first and second ECG leads 350A and 350B. Second and / or optional third electrically-isolating element(s) 340B and / or 340C may be configured to operate in a manner similar to that of first electrically-isolating element 340A shown in, for example, FIG. 3B2.[000159] FIG. 3D1 provides a schematic diagram of a top plan view of a fourth exemplary fetal ECG measurement device 175D that includes a fourth housing 305D and positioning extension 310, which includes cord 320, optional inflation line 315, optional internal reference electrode 380, and optional maternal temperature sensor 337. Fourth housing 305D houses first ECG lead 350A, second ECG lead 350B, thirdECG lead 350C, optional fetal temperature sensor 335, optional marker 339, optional engagement feature(s) 352, and a first exemplary mechanical barrier 360 comprising a vertical component 360A positioned between second and third ECG leads 350B and 350C and a horizontal component 360B positioned between first and second ECG leads 350A and 350B. Mechanical barrier 360, vertical component 360A and / or horizontal component 360B may be embodied as a projection that extends (e.g., 0.1-5mm) above fourth housing 305D and / or a contact surface of first, second, and third ECG leads 350A, 350B, and 350C as shown. First mechanical barrier 360 may be, for example, “T-shaped and / or have any other shape (e.g., a “Y”-shape) that allows it to be positioned between first, second, and third ECG leads 350A, 350B, and 350C. First mechanical barrier 360 may be configured to, for example, standardize and / or control a magnitude of impedance induced by amniotic fluid across first, second, and / or third ECG leads 350A, 350B, and 350C by, for example, creating a standard thickness of the fluid layer positioned between first, second, and / or third ECG lead(s) 350A, 350B, and / or 350C and fetal skin that may be less sensitive to scenarios when first, second, and third ECG lead(s) 350A, 350B, and / or 350C is / are separated and / or partially lifted away from fetal skin.[000160] FIG. 3D2 provides a schematic diagram of a vertical cross section of fourth housing 305D taken along cross section line 3D2-3D2 and shows how vertical component 360A extends proud from a surface of fourth housing 305D to isolate first and second ECG leads 350A and 350B from third ECG lead 350C (not shown). FIG.3D2 also shows how horizontal component 360B extends proud from the surface of fourth housing 305D to isolate first ECG lead 350A from second ECG lead 350B.[000161] FIG. 3D3 provides a schematic diagram of a horizontal cross section (taken along line 3D3-3D3 of FIG. 3D1) of fourth exemplary fetal ECG measurement device 175D when positioned in utero proximate to fetal skin 290. As may be seen in FIG. 3D3, when fourth housing 305D is positioned proximate to fetal skin 292 in utero, horizontal component 360B may contact fetal skin 292 and electrically isolate a first volume of amniotic fluid 396 proximate to and / or in electrical contact with second ECG lead 350B from a second volume of amniotic fluid 297 that may be proximate to and / or in electrical contact with third ECG lead 350C.[000162] FIG. 3E1 provides a schematic diagram of a top plan view of a fifth exemplary fetal ECG measurement device 175E that includes positioning extension 310, which includes cord 320, optional inflation line 315, optional internal referenceelectrode 380, optional engagement feature(s) 352, optional maternal temperature sensor 337, and a fifth housing 305E that houses the first ECG lead 350A, second ECG lead 350B (which may be optional), third ECG lead 350C (which may be optional), optional fetal temperature sensor 335, optional marker 339, and an exemplary second mechanical barrier embodied as a trough that is depressed (e.g., 0.1-5mm) into a surface of fifth housing 305E proximate to a contact surface of first, second, and third ECG leads 350A, 350B, and 350C as shown. Second mechanical barrier 365 may be configured to, for example, standardize and / or control a magnitude of impedance induced by amniotic fluid across first, second, and third ECG leads 350A, 350B, and 350C by, for example, creating a standard thickness of the fluid layer positioned between first, second, and / or third ECG lead(s) 350A, 350B, and / or 350C and fetal skin that may be less sensitive to scenarios when first, second, and third ECG leads 350A, 350B, and / or 350C is separated and / or partially lifted away from fetal skin.[000163] In some embodiments, second mechanical barrier 365 may be configured to drain amniotic fluid away from fetal skin by, for example, directing the amniotic fluid away from the fetal skin and / or containing the amniotic fluid, thereby leaving an air gap between second and third ECG leads 350B and 350C so that second and third ECG leads 350B and 350C touch and / or are in contact with the fetal skin without any intervening amniotic fluid. Optionally barriers 366 may be positioned at an edge of and / or surrounding first, second, and / or third ECG leads 350A, 350B, and / or 350C may create an air gap 398 as, for example shown in FIG. 3E3. In some embodiments, optional barrier 366 may comprise and / or be coated with a hydrophilic material and first, second, and / or third ECG leads 350A, 350B, and / or 350C and / or areas proximate to first, second, and / or third ECG leads 350A, 350B, and / or 350C may comprise and / or be coated with hydrophobic materials to assist with wicking the amniotic fluid away from first, second, and / or third ECG leads 350A, 350B, and / or 350C.[000164] FIG. 3E2 provides a schematic diagram of a cross section view of fifth housing 305E taken along section line 3E2-3E2 when positioned in utero proximate to fetal skin 290. As may be seen in FIG. 3E2, second and third ECG leads 350B and 350C may be positioned proximate to fetal skin 290and a portion of ambient amniotic fluid 399 may be positioned within trough 365, which may act to standardize and / orcontrol a magnitude of impedance induced by amniotic fluid across second and third ECG leads 350B and 350C.[000165] First, second, third, fourth, and / or fifth housings 305A, 305B, 305C, 305D, and 305E may be physically coupled (e.g., bonded, affixed, and / or joined) to positioning extension 310. In some cases, a joint between first, second, third, fourth, and / or fifth housings 305A, 305B, 305C, 305D, and 305E and positioning extension 310 may be configured to articulate to, for example, enable insertion and / or proper positioning of housing 305A, 305B, 305C, 305D, and / or 305E on fetal skin and / or within the uterus so that it may be electrically coupled to the fetus via contact with fetal skin and / or conductive (e.g., amniotic) fluid.[000166] In some embodiments, positioning extension 310 may also include optional inflation line 315 with a lumen therein configured to provide inflating fluid (e.g., saline, air, water, etc.) to an optional inflatable stabilization device 325 (see e.g., FIG.3F). Optional inflatable stabilization device 325 may be configured to be positioned between an active surface of first, second, third, fourth, and / or fifth housings 305A, 305B, 305C, 305D, and 305E (e.g., a surface that holds first, second, and / or third ECG lead 350A, 350B, and / or 350C) and an internal uterine wall. Optional inflatable stabilization device 325 may be inflated and / or adjusted to occupy space between fetal skin and a uterine wall so that it presses the active surface of first, second, third, fourth and / or fifth fetal ECG measurement device 175A, 175B, 175C, 175D and / or 175E, first, second, and / or third ECG leads 350A, 350B, and / or 350C, and / or first, second, third, fourth, and / or fifth housings 305A, 305B, 305C, 305D, and 305E against the fetal skin and / or assists with maintaining contact between the fetal skin and an ECG lead 350 (e.g., first, second, and / or third ECG leads 350A, 350B, and / or 350C). In some embodiments, a degree to which optional inflatable stabilization device 325 is inflated / deflated may be responsive to, for example, a degree of back pressure exerted on optional inflation line 315 (as measured by, for example, an optional pressure gauge 382 (shown in FIG. 3F)), a degree of pressure required to further inflate optional inflatable stabilization device 325 (as, for example, measured by optional pressure gauge 382), and / or a measurement taken from one or more components of fetal ECG measurement device 175A, 175B, 175C, and / or 175D (e.g., a degree of inflation may be adjusted so to establish and / or improve the readings from first, second, and / or third ECG lead(s) 350A, 350B, and / or 350C). Optional pressure gauge 382 may be, forexample, an analog pressure meter, a force meter, a Bourdon pressure gauge, and / or a pressure-sensitive resistance meter.[000167] Additionally, or alternatively, in some embodiments, a degree of inflation of optional inflatable stabilization device 325 may be responsive to a position of the fetus within the uterus and / or birth canal and may be configured to, for example, deflate as a labor and delivery process of the fetus transitions from, for example, the first to the second stage of labor. Deflation of optional inflatable stabilization device 325 in this manner may assist with reducing an overall size / profile of first, second, third, fourth, or fifth fetal ECG measurement device 175A, 175B, 175C, 175D, or 175E so that, for example, it does not interfere with the movement of the fetus through the birth canal during delivery.[000168] In some embodiments, optional inflatable stabilization device 325 may be configured to expand and / or fill space until an external pressure is exerted thereon. In these embodiments, optional inflatable stabilization device 325 may comprise a material (e.g., foam) configured to expand upon contact with water or amniotic fluid and fill a space between fetal skin and an inner uterine wall so that, for example, an ECG lead 350 may contact and / or be held in place relative to fetal skin or be electrically coupled to the fetus via a conductive fluid like amniotic fluid. Additionally, or alternatively, optional inflatable stabilization device 325 may comprise a deformable material (e.g., gel and / or memory foam) configured to deform and / or mold to fill a space between fetal skin and an inner uterine wall, thereby providing a close fit between an active, ECG lead containing side of first, second, third, fourth, and / or fifth housings 305A, 305B, 305C, 305D, and 305E and fetal skin.[000169] In some embodiments, first, second, third, fourth, and / or fifth housings 305A, 305B, 305C, 305D, and 305E may further include an optional ECG lead 355 configured and positioned to contact and / or be electrically coupled with a pregnant mammal’s uterine wall as shown in the side views of FIGs. 3F and 3G, wherein FIG.3G is a side view of first, second, third, fourth or fifth fetal ECG measurement device 175A, 175B, 175C, 175D, or 175E that includes an exemplary extension 270 positioned on an outer surface of first, second, third, fourth, and / or fifth housings 305A, 305B, 305C, 305D, and 305E opposite the active surface thereof that includes ECG lead 350 and / or first, second, and third ECG leads 350A, 350B, and 350C as shown. ECG lead 355 may be positioned anywhere along the back side of, for example, extension 270. Extension 270 may be configured to assist with the positioning and / ormaintaining a position of first, second, third, fourth, or fifth fetal ECG measurement device 175A, 175B, 175C, 175D, or 175E against fetal skin and / or proximate enough to the fetal skin to electrically couple to the fetus within a pregnant mammal’s uterus by, for example, exerting a force on the uterine wall that acts to push first, second, third, fourth, or fifth fetal ECG measurement device 175A, 175B, 175C, 175D, or 175E in the opposite direction (i.e., toward fetal skin) and, in this way, may help with keeping first, second, third, fourth, or fifth fetal ECG measurement device 175A, 175B, 175C, 175D, or 175E correctly in contact with fetal skin and / or electrically coupled to the fetus. In some embodiments, extension 270 may be flexible and / or configured to apply a controlled range of force the uterine wall, which is translated into pressing into the fetal skin and / or fetal cheek.[000170] FIG. 3A provides a schematic diagram of a top plan view of a first exemplary system 301 that includes a first fetal ECG measurement device 175A and an optional external reference electrode 385 that may be put in contact with non-fetal tissue such as a vaginal canal or maternal leg. First fetal ECG measurement device 175A includes a positioning extension 310 that houses an optional inflation line 315, an optional marker 339, and a cord, or wire, 320 configured to, for example, provide electricity to first ECG measurement device 175A and / or enable communication of, for example, ECG signals received by an ECG lead 350 to computer and / or processor 150. First fetal ECG measurement device 175A also includes a first housing 305A sized, shaped, and configured to house ECG lead 350, and required circuitry for its operation and communication with system 100 and / or components thereof such as a communicative coupling between ECG lead 350 and wire 320. In some embodiments, positioning extension 310 may include an internal reference electrode 380 positioned and configured to contact and / or electrically couple to maternal tissue such as the uterus, cervix, and / or vagina. In some embodiments, data from first fetal ECG measurement device 175A may be used with data from internal reference electrode 380 and / or an optional external reference electrode 385 to, for example, perform one or more methods disclosed herein.[000171] Optionally, first exemplary system 301 and / or first housing 305A may include a fetal temperature sensor 335 configured to sense a temperature of the fetus and / or uterus while first housing 305A is in situ proximate to fetal skin. Additionally, or alternatively, first fetal ECG measurement device 175A (e.g., positioning extension 310) may include a maternal temperature sensor 337 configured to sense atemperature of maternal tissue (e.g., the cervix and / or vagina) while, for example, positioning extension 310 is positioned therein and / or first housing 305A is in situ proximate to fetal skin. Additionally, or alternatively, first fetal ECG measurement device 175A and / or first housing 305A may include an optional marker 339 configured to, for example, be opaque when one or more imaging technologies are used to image the fetal and / or maternal tissue. For example, marker 339 may be echogenically and / or radio opaque so that it is easily visualized when, for example, a pregnant mammal’s abdomen and / or the fetus is imaged using, for example, ultrasound and / or other imaging technology. Thus, marker 339 may be configured to assist clinicians with visualization of a position of first housing 305A and / or first fetal ECG measurement device 175A relative to maternal and / or fetal anatomy during use.[000172] Additionally, or alternatively, first fetal ECG measurement device 175A may include one or more optional engagement feature(s) 352 configured to increase friction and / or grippiness between first housing 305A and the fetal skin. Engagement feature(s) 352 may include, for example, a rubber or silicone feature that has an approximately uniform smooth surface, an approximately uniform rough surface, and / or a plurality of features (e.g., ridges, nubs, and / or divots) configured to removably engage with fetal skin and increase a coefficient of friction between the fetal skin and first housing 305A, thereby decreasing a likelihood that first housing 305A will slip off, or otherwise disengage from, the fetal skin. The features of engagement feature(s) 352 may be arranged in any pattern (e.g., dots, stripes, zig-zags, curved lines, etc.). Although engagement feature(s) 352 are shown to surround an exterior of first housing 305A, this need not always be the case. For example, in some embodiments, one or more engagement feature(s) 352 may be positioned on a surface of first housing 305A including ECG lead 350 and / or another (e.g., back or side) surface of first housing 305A and / or positioning extension 310.[000173] FIG. 3B1 provides a schematic diagram of a top plan view of a second exemplary fetal ECG measurement device 175B that includes positioning extension 310, optional inflation line 315, cord 320, optional engagement feature(s) 352, and optional maternal temperature sensor 337. Second fetal ECG measurement device 175B also includes a second housing 305B sized, shaped, and configured to house a first ECG lead 350A, a second ECG lead 350B, optional fetal temperature sensor 335, optional marker 339, and circuitry used for operation of second exemplary fetal ECG measurement device 175B and communication with system 100 and / or componentsthereof (e.g., communicative and / or electrical couplings between first and second ECG leads 350A, 350B, and optional temperature sensor and cord 320).[000174] Second housing 305B also includes a first optional non-conductive, electrically-isolating element 340A (also referred to herein as “first electrically-isolating element 340A”) sized, configured, and positioned to surround first ECG lead 350A and electrically isolate it from second ECG lead 350B and a second optional non-conductive, electrically-isolating, element 340B (also referred to herein as “second electrically-isolating element 340B”) sized, configured, and positioned to surround second ECG lead 350B and electrically isolate it from first ECG lead 350A. First and / or second optional electrically-isolating element(s) 340A and / or 340B may be embodied as a raised projection that extends above (e.g., 0.1 -5mm) a surface of first and / or second ECG lead(s) 350A and / or 350B that acts to contain any fluid (e.g., amniotic fluid) surrounding their respective ECG leads so that the first and second ECG leads 350A and 350B and fluid proximate thereto are electrically isolated from one another, thereby preventing electrical communication between first and second ECG leads 350A and 350B via, for example, amniotic fluid. In some embodiments, second fetal ECG measurement device 175B may include only first or second electrically-isolating element 340A or 340B. For example, first electrically-isolating element 340A may electrically insulate ECG lead 350A from ECG lead 350B without second electrically-isolating element 340B.[000175] FIG. 3B2 provides a schematic diagram of a cross section (taken along line 3B2-3B2 of FIG. 3B1) of second exemplary fetal ECG measurement device 175B when positioned in utero proximate to fetal skin. As may be seen in FIG. 3B2, when second exemplary fetal ECG measurement device 175B is positioned proximate to fetal skin 292 in utero, first electrically-isolating element 340A may contact fetal skin 292 and electrically isolate a volume of amniotic fluid 394 from a surrounding, ambient, volume of amniotic fluid that may, or may not, be in electrical contact with second ECG lead 350B. Optional second electrically-isolating element 340B may be configured to operate in a manner similar to that of first electrically-isolating element 340A shown in, for example, FIG. 3B2.[000176] FIG. 3C provides a schematic diagram of a top plan view of a third exemplary fetal ECG measurement device 175C that includes all the components of second fetal ECG measurement device 175B as well as a third ECG lead 350C and a third optional electrically-isolating element 340C sized, configured, and positioned tosurround third ECG lead 350C and electrically isolate it from first and second ECG leads 350A and 350B. Second and / or optional third electrically-isolating element(s) 340B and / or 340C may be configured to operate in a manner similar to that of first electrically-isolating element 340A shown in, for example, FIG. 3B2.[000177] FIG. 3D1 provides a schematic diagram of a top plan view of a fourth exemplary fetal ECG measurement device 175D that includes a fourth housing 305D and positioning extension 310, which includes cord 320, optional inflation line 315, optional internal reference electrode 380, and optional maternal temperature sensor 337. Fourth housing 305D houses first ECG lead 350A, second ECG lead 350B, third ECG lead 350C, optional fetal temperature sensor 335, optional marker 339, optional engagement feature(s) 352, and a first exemplary mechanical barrier 360 comprising a vertical component 360A positioned between second and third ECG leads 350B and 350C and a horizontal component 360B positioned between first and second ECG leads 350A and 350B. Mechanical barrier 360, vertical component 360A and / or horizontal component 360B may be embodied as a projection that extends (e.g., 0.1-5mm) above fourth housing 305D and / or a contact surface of first, second, and third ECG leads 350A, 350B, and 350C as shown. First mechanical barrier 360 may be, for example, “T-shaped and / or have any other shape (e.g., a “Y”-shape) that allows it to be positioned between first, second, and third ECG leads 350A, 350B, and 350C. First mechanical barrier 360 may be configured to, for example, standardize and / or control a magnitude of impedance induced by amniotic fluid across first, second, and / or third ECG leads 350A, 350B, and 350C by, for example, creating a standard thickness of the fluid layer positioned between first, second, and / or third ECG lead(s) 350A, 350B, and / or 350C and fetal skin that may be less sensitive to scenarios when first, second, and third ECG lead(s) 350A, 350B, and / or 350C is / are separated and / or partially lifted away from fetal skin.[000178] FIG. 3D2 provides a schematic diagram of a vertical cross section of fourth housing 305D taken along cross section line 3D2-3D2 and shows how vertical component 360A extends proud from a surface of fourth housing 305D to isolate first and second ECG leads 350A and 350B from third ECG lead 350C (not shown). FIG.3D2 also shows how horizontal component 360B extends proud from the surface of fourth housing 305D to isolate first ECG lead 350A from second ECG lead 350B.[000179] FIG. 3D3 provides a schematic diagram of a horizontal cross section (taken along line 3D3-3D3 of FIG. 3D1) of fourth exemplary fetal ECG measurementdevice 175D when positioned in utero proximate to fetal skin 290. As may be seen in FIG. 3D3, when fourth housing 305D is positioned proximate to fetal skin 292 in utero, horizontal component 360B may contact fetal skin 292 and electrically isolate a first volume of amniotic fluid 396 proximate to and / or in electrical contact with second ECG lead 350B from a second volume of amniotic fluid 297 that may be proximate to and / or in electrical contact with third ECG lead 350C.[000180] FIG. 3E1 provides a schematic diagram of a top plan view of a fifth exemplary fetal ECG measurement device 175E that includes positioning extension 310, which includes cord 320, optional inflation line 315, optional internal reference electrode 380, optional engagement feature(s) 352, optional maternal temperature sensor 337, and a fifth housing 305E that houses the first ECG lead 350A, second ECG lead 350B (which may be optional), third ECG lead 350C (which may be optional), optional fetal temperature sensor 335, optional marker 339, and an exemplary second mechanical barrier embodied as a trough that is depressed (e.g., 0.1-5mm) into a surface of fifth housing 305E proximate to a contact surface of first, second, and third ECG leads 350A, 350B, and 350C as shown. Second mechanical barrier 365 may be configured to, for example, standardize and / or control a magnitude of impedance induced by amniotic fluid across first, second, and third ECG leads 350A, 350B, and 350C by, for example, creating a standard thickness of the fluid layer positioned between first, second, and / or third ECG lead(s) 350A, 350B, and / or 350C and fetal skin that may be less sensitive to scenarios when first, second, and third ECG leads 350A, 350B, and / or 350C is separated and / or partially lifted away from fetal skin.[000181] In some embodiments, second mechanical barrier 365 may be configured to drain amniotic fluid away from fetal skin by, for example, directing the amniotic fluid away from the fetal skin and / or containing the amniotic fluid, thereby leaving an air gap between second and third ECG leads 350B and 350C so that second and third ECG leads 350B and 350C touch and / or are in contact with the fetal skin without any intervening amniotic fluid. Optionally barriers 366 may be positioned at an edge of and / or surrounding first, second, and / or third ECG leads 350A, 350B, and / or 350C may create an air gap 398 as, for example shown in FIG. 3E3. In some embodiments, optional barrier 366 may comprise and / or be coated with a hydrophilic material and first, second, and / or third ECG leads 350A, 350B, and / or 350C and / or areas proximate to first, second, and / or third ECG leads 350A, 350B, and / or 350Cmay comprise and / or be coated with hydrophobic materials to assist with wicking the amniotic fluid away from first, second, and / or third ECG leads 350A, 350B, and / or 350C.[000182] FIG. 3E2 provides a schematic diagram of a cross section view of fifth housing 305E taken along section line 3E2-3E2 when positioned in utero proximate to fetal skin 290. As may be seen in FIG. 3E2, second and third ECG leads 350B and 350C may be positioned proximate to fetal skin 290and a portion of ambient amniotic fluid 399 may be positioned within trough 365, which may act to standardize and / or control a magnitude of impedance induced by amniotic fluid across second and third ECG leads 350B and 350C.[000183] First, second, third, fourth, and / or fifth housings 305A, 305B, 305C, 305D, and 305E may be physically coupled (e.g., bonded, affixed, and / or joined) to positioning extension 310. In some cases, a joint between first, second, third, fourth, and / or fifth housings 305A, 305B, 305C, 305D, and 305E and positioning extension 310 may be configured to articulate to, for example, enable insertion and / or proper positioning of housing 305A, 305B, 305C, 305D, and / or 305E on fetal skin and / or within the uterus so that it may be electrically coupled to the fetus via contact with fetal skin and / or conductive (e.g., amniotic) fluid.[000184] In some embodiments, positioning extension 310 may also include optional inflation line 315 with a lumen therein configured to provide inflating fluid (e.g., saline, air, water, etc.) to an optional inflatable stabilization device 325 (see e.g., FIG.3F). Optional inflatable stabilization device 325 may be configured to be positioned between an active surface of first, second, third, fourth, and / or fifth housings 305A, 305B, 305C, 305D, and 305E (e.g., a surface that holds first, second, and / or third ECG lead 350A, 350B, and / or 350C) and an internal uterine wall. Optional inflatable stabilization device 325 may be inflated and / or adjusted to occupy space between fetal skin and a uterine wall so that it presses the active surface of first, second, third, fourth and / or fifth fetal ECG measurement device 175A, 175B, 175C, 175D and / or 175E, first, second, and / or third ECG leads 350A, 350B, and / or 350C, and / or first, second, third, fourth, and / or fifth housings 305A, 305B, 305C, 305D, and 305E against the fetal skin and / or assists with maintaining contact between the fetal skin and an ECG lead 350 (e.g., first, second, and / or third ECG leads 350A, 350B, and / or 350C). In some embodiments, a degree to which optional inflatable stabilization device 325 is inflated / deflated may be responsive to, for example, a degree of back pressure exertedon optional inflation line 315 (as measured by, for example, an optional pressure gauge 382 (shown in FIG. 3F)), a degree of pressure required to further inflate optional inflatable stabilization device 325 (as, for example, measured by optional pressure gauge 382), and / or a measurement taken from one or more components of fetal ECG measurement device 175A, 175B, 175C, and / or 175D (e.g., a degree of inflation may be adjusted so to establish and / or improve the readings from first, second, and / or third ECG lead(s) 350A, 350B, and / or 350C). Optional pressure gauge 382 may be, for example, an analog pressure meter, a force meter, a Bourdon pressure gauge, and / or a pressure-sensitive resistance meter.[000185] Additionally, or alternatively, in some embodiments, a degree of inflation of optional inflatable stabilization device 325 may be responsive to a position of the fetus within the uterus and / or birth canal and may be configured to, for example, deflate as a labor and delivery process of the fetus transitions from, for example, the first to the second stage of labor. Deflation of optional inflatable stabilization device 325 in this manner may assist with reducing an overall size / profile of first, second, third, fourth, or fifth fetal ECG measurement device 175A, 175B, 175C, 175D, or 175E so that, for example, it does not interfere with the movement of the fetus through the birth canal during delivery.[000186] In some embodiments, optional inflatable stabilization device 325 may be configured to expand and / or fill space until an external pressure is exerted thereon. In these embodiments, optional inflatable stabilization device 325 may comprise a material (e.g., foam) configured to expand upon contact with water or amniotic fluid and fill a space between fetal skin and an inner uterine wall so that, for example, an ECG lead 350 may contact and / or be held in place relative to fetal skin or be electrically coupled to the fetus via a conductive fluid like amniotic fluid. Additionally, or alternatively, optional inflatable stabilization device 325 may comprise a deformable material (e.g., gel and / or memory foam) configured to deform and / or mold to fill a space between fetal skin and an inner uterine wall, thereby providing a close fit between an active, ECG lead containing side of first, second, third, fourth, and / or fifth housings 305A, 305B, 305C, 305D, and 305E and fetal skin.[000187] In some embodiments, first, second, third, fourth, and / or fifth housings 305A, 305B, 305C, 305D, and 305E may further include an optional ECG lead 355 configured and positioned to contact and / or be electrically coupled with a pregnant mammal’s uterine wall as shown in the side views of FIGs. 3F and 3G, wherein FIG.3G is a side view of first, second, third, fourth or fifth fetal ECG measurement device 175A, 175B, 175C, 175D, or 175E that includes an exemplary extension 270 positioned on an outer surface of first, second, third, fourth, and / or fifth housings 305A, 305B, 305C, 305D, and 305E opposite the active surface thereof that includes ECG lead 350 and / or first, second, and third ECG leads 350A, 350B, and 350C as shown. ECG lead 355 may be positioned anywhere along the back side of, for example, extension 270. Extension 270 may be configured to assist with the positioning and / or maintaining a position of first, second, third, fourth, or fifth fetal ECG measurement device 175A, 175B, 175C, 175D, or 175E against fetal skin and / or proximate enough to the fetal skin to electrically couple to the fetus within a pregnant mammal’s uterus by, for example, exerting a force on the uterine wall that acts to push first, second, third, fourth, or fifth fetal ECG measurement device 175A, 175B, 175C, 175D, or 175E in the opposite direction (i.e., toward fetal skin) and, in this way, may help with keeping first, second, third, fourth, or fifth fetal ECG measurement device 175A, 175B, 175C, 175D, or 175E correctly in contact with fetal skin and / or electrically coupled to the fetus. In some embodiments, extension 270 may be flexible and / or configured to apply a controlled range of force the uterine wall, which is translated into pressing into the fetal skin and / or fetal cheek.[000188] FIG. 3H provides a schematic diagram of a diagram of a top view of an exemplary fetal ECG measurement device 175F that is configured for placement on a presenting fetal head without entering the uterus (e.g., attached via insertion through the vagina and / or cervix). Fetal ECG measurement device 175F includes a first base 390A that holds optional fetal temperature sensor 335, optional marker 339, optional ECG lead 355, and first, second, and third ECG leads 350A, 350B, and 350C. An outer perimeter of base 390 is encircled by an optional attachment feature 392 configured to assist with holding fetal ECG measurement device 175F in place on the fetal head via a suction fit that may be similar to the way a suction cup fits to a surface. Attachment feature 392 may be, for example, an adhesive and / or a mechanical coupling device like a flange that may expand outward when fetal ECG measurement device 175F is pressed into fetal skin (e.g., presenting head) in a manner similar to that of a suction cup.[000189] FIG. 3I provides a schematic diagram of a diagram of a top view of another exemplary fetal ECG measurement device 175G that is configured for placement on a presenting fetal head without entering the uterus (e.g., attached viainsertion through the vagina and / or cervix). Fetal ECG measurement device 175G includes a second base 390B, which holds a single ECG lead 350, optional marker 339, and optional attachment feature 392. In some embodiments, an ECG lead 350 may be incorporated into and / or instantized in attachment feature 392 as shown in FIG. 3C, which provides a schematic diagram of a top view of a fetal ECG measurement device 175H that is configured for placement on a presenting fetal head without entering the uterus (e.g., attached via insertion through the vagina and / or cervix). Fetal ECG measurement device 175H includes a single ECG lead 350, optional marker 339, and optional fetal temperature sensor 335.[000190] When attachment feature 392 is insufficient, or not present, fetal ECG measurement device(s) 175F, 175G, and / or 175H may be attached to the skin of the fetal head via any appropriate means including, but not limited to, tape, gel, and / or an adhesive.[000191] As may be seen in the schematic diagram of a cross-section view of FIG.3K taken along line 3K-3K of FIGs. 3H, 3I, or 3J, fetal ECG measurement devices 175F, 175G, and 175H may also include an optional positioning device 425 configured to assist with the insertion of fetal ECG measurement device 175F into the vagina and / or attaching first, second, or third base 390A, 390B, or 390C to the fetal head so that one or more ECG leads 350 may be proximate to and / or in electrical contact with fetal skin and optional attachment feature 392 may be engaged to, for example, hold fetal ECG measurement devices 175F, 175G, or 175H in place during use. In some embodiments, positioning device 425 may be configured in a manner similar to positioning extension 410. Positioning device 425 may include cord 320 and optional maternal temperature sensor 337. Additionally, or alternatively, in some embodiments, positioning extension 410 may be configured to decouple from first, second, and / or third base 390A, 390B, and / or 390C via, for example, a mechanical or magnetic coupling between positioning extension 410 and first, second, and / or third base 390A, 390B, and / or 390C. Optionally, fetal ECG measurement devices 175F, 175G, and 175H may also include internal reference electrode 380 resident within and / or extending from positioning device 425. Additionally, or alternatively, fetal ECG measurement devices 175F, 175G, and 175H may be included in a system comprising fetal ECG measurement devices 175F, 175G, and 175H may also include and external reference electrode 385. Optionally, fetal ECG measurement devices 175F, 175G, and 175H may also include ECG lead 355 which may be configured and / or positionedto contact maternal tissue (e.g., cervix and / or vagina) and, in some instances, may provide reference electrode data.[000192] FIG. 4 provides a diagram of a combined fetal ECG and direct-measurement-fetal-oximetry sensor 400 that includes a housing 405 that houses a set of components 410 that includes at least one ECG lead like 350, a light source like light source(s) 105 and / or 236, and a detector like detector 160 (not shown). A layout and / or combination of components for combined fetal ECG and direct-measurement-fetal-oximetry sensor 400 may be similar to the layout and / or combination of components for the fetal ECG and the direct-measurement-fetal-oximetry sensors described herein. In addition, combined fetal ECG and direct-measurement-fetal-oximetry sensor 400 may include positioning extension 210, inflation line 215, cord 220, and / or reference electrode 244. Combined fetal ECG and direct-measurement-fetal-oximetry sensor 400 may be configured to measure / obtain both fetal oximetry signals as well fetal ECG signals as, for example, described herein. Combined fetal ECG and direct-measurement-fetal-oximetry sensor 400 may have one or more of the positioning devices disclosed herein with regard to fetal ECG device(s) 175A, 175B, 175C, 175D, or 175E and / or direct-measurement-fetal-oximetry sensor 200, 201, 202, or 204.[000193] FIG. 5A is a schematic diagram illustrating a cross-section view of a pregnant human woman with fetal ECG measurement device 175A, 175B, 175C, 175D, 175E, direct-measurement-fetal-oximetry sensor 200, or combined fetal ECG and direct-measurement-fetal-oximetry sensor 400 positioned within her uterus as defined by uterine wall 260 when her cervix 267 is partially (e.g., 1-10cm) dilated. As may be seen in FIG. 5A, an active side fetal ECG measurement device 175A, 175B, 175C, 175D, 175E, direct-measurement-fetal-oximetry sensor 200, or combined fetal ECG and direct-measurement-fetal-oximetry sensor 400 is in contact with a scalp of a fetus 280 and stabilization device 225 or 325 is inflated to occupy space in the uterus between the fetal scalp and uterine wall 260, thereby holding the active side in place relative to the fetal cheek by, for example, wedging direct-measurement-fetal-oximetry sensor 200 between the fetal scalp and uterine wall 260. Inflation of stabilization device 225 or 325 in the manner shown in FIG. 5A may assist with establishing, and maintaining, contact between the active side of fetal ECG measurement device 175A, 175B, 175C, 175D, 175E, direct-measurement-fetal-oximetry sensor 200, or combined fetal ECG and direct-measurement-fetal-oximetrysensor 400 even during the labor and delivery process when the uterus is contracting and relaxing (e.g., a distance between the uterine wall and the fetal cheek is dynamic and stabilization device 225 or 325 may be configured (e.g., made of flexible silicone or vinyl) to adjust its size and / or where inflation media (e.g., air or saline) is positioned according to the dynamic geometry between fetus 280 and uterine wall 260).[000194] FIG. 5B is a schematic diagram illustrating a cross-section view of a pregnant human woman with fetal ECG measurement device 175A, 175B, 175C, 175D, 175E, direct-measurement-fetal-oximetry sensor 201, or combined fetal ECG and direct-measurement-fetal-oximetry sensor 400 positioned within her uterus against fetus’s 280 scalp proximate to the fetus’ ear, when her cervix 267 is, for example, 1-10cm dilated. As may be seen in FIG. 5C, extension 270 or 370 is positioned between uterine wall 260 and the fetal scalp so it may occupy space between the fetal scalp and uterine wall as shown to assist with establishing, and maintaining, contact between an active side 230 of fetal ECG measurement device 175A, 175B, 175C, 175D, 175E, direct-measurement-fetal-oximetry sensor 201 , or combined fetal ECG and direct-measurement-fetal-oximetry sensor 400 and the fetal scalp even during the labor and delivery process when the uterus is contracting and relaxing and the fetus is descending through the cervix (e.g., a distance between the uterine wall and the fetal cheek is dynamic).[000195] FIG. 5C is a schematic diagram illustrating a cross-section view of a pregnant human woman with fetal ECG measurement device 175, direct-measurement-fetal-oximetry sensor 202, or combined fetal ECG and direct-measurement-fetal-oximetry sensor 400 positioned within her uterus against fetus’s 210 scalp proximate to the fetus’ ear, when her cervix 267 is, for example, 1-10cm dilated. As may be seen in FIG. 5C, extension 275 is positioned between uterine wall 260 and the fetal scalp so that it may occupy space between the fetal scalp and uterine wall as shown to, for example, assist with establishing, and maintaining, contact between an active side of fetal ECG measurement device 175, direct-measurement-fetal-oximetry sensor 202, or combined fetal ECG and direct-measurement-fetal-oximetry sensor 400 and the fetal scalp even during the labor and delivery process when the uterus is contracting and relaxing and the fetus is descending through the cervix (e.g., a distance between the uterine wall and the fetal cheek is dynamic).[000196] FIG. 5D is a schematic diagram illustrating a cross-section view of a pregnant human woman with fetal ECG measurement device 175, direct-measurement-fetal-oximetry sensor 204, or combined fetal ECG and direct-measurement-fetal-oximetry sensor 400 positioned within her uterus as defined by uterine wall 260 when her cervix 267 is partially (e.g., 1-10cm) dilated. As may be seen in FIG. 5D, an active side fetal ECG measurement device 175, direct-measurement-fetal-oximetry sensor 204, or combined fetal ECG and direct-measurement-fetal-oximetry sensor 400 is in contact with a scalp of a fetus 280 and maternal optical sensor side 232 (in this case, the side opposing active side 230) of direct-measurement-fetal-oximetry sensor 204 including the set of maternal optical sensors is positioned proximate to (e.g., touching and / or in optical contact with) maternal tissue, in this case an interior surface of uterine wall 260. When in position as, for example, shown in FIG. 5D, a set of maternal optical sensors maternal optical sensor side 232 may obtain maternal optical and / or oximetry information by, for example emitting light (via, for example, light source 205) into uterine wall 260 and detecting (via, for example, one or more detectors 160) resulting light that is backscattered from the maternal tissue.[000197] FIG. 6 provides a flowchart illustrating a method 600 for generating an electrocardiogram (ECG) for a fetus and / or determining a fetal heart rate using, for example, one or more of the systems, devices, and / or system components disclosed herein.[000198] Initially, in step 605, data are received from one or more ECG leads in electrical contact with fetal skin while the fetus is still in utero or has entered the birth canal. At times, the ECG data received in step 605 may be raw ECG data received from, for example, first, second, and / or third ECG lead(s) 350A, 350B, and / or 350C. In some embodiments, the one or more ECG leads may be positioned on an outside surface of a pregnant mammal’s amniotic sac and electrical communication with the fetal skin may be facilitated by amniotic fluid present within the amniotic sac. Additionally, or alternatively, the one or more ECG leads may be positioned inside of a pregnant mammal’s amniotic sac and / or uterus before the fetal head enters the pregnant mammal’s cervix and / or vagina. In some embodiments, temperature data from, for example, fetal temperature sensor 335 and / or maternal temperature sensor 337 may be received in step 605.[000199] Optionally, in step 610, it may be determined whether there is an indication of an error condition present in the data received in step 605 as may occur when one or more of the ECG leads is not in contact with the fetal skin (e.g., floating in amniotic fluid or air) and, if so, providing an indication of the error to a output device (e.g., output and / or printout device 180) in communication with a processor (e.g., computer and / or processor 150) performing method 600 (step 615). In some embodiments, execution of step 610 may include determining a level of impedance indicated by the received data and providing an error indication to the output device responsively to an indication that the level of impedance is outside (e.g., above or below) a range of values (e.g., 1,900-16,000 ohms, 1,000-20,000 ohms or 800-25,000 ohms). Additionally, or alternatively, execution of step 610 may include determining a level of electrical shunting indicated by the received data and providing an error indication to the output device responsively to an indication that the level of electrical shunting is above a threshold. Execution of step 615 may include illuminating an error light (e.g., a yellow or blue LED or series of LEDs) or displaying a message such as the phrase(s) “lead off” and / or “insufficient contact” on an output device like output and / or printout device 180. Additionally, or alternatively, the error indication may be an instruction and / or recommendation that may reduce an effect of the error. For example, when the one or more ECG leads are positioned within first, second, third, fourth, and / or fifth housing 305A, 305B, 305C, 305D, or 305E, the error indication may include an instruction or recommendation to adjust an orientation and / or position of positioning extension 310, adjust an orientation and / or position of first, second, third, fourth, or fifth housing 305A, 305B, 305C, 305D, or 305E, and / or adjust a level of inflation of optional inflatable stabilization device 325.[000200] Optionally, in step 620, the ECG data (e.g., raw ECG data) may be conditioned (e.g., using analog filtering, digital filtering, amplification, etc.) or otherwise processed to, for example, calculate the voltage difference between the ECG electrode and selected reference electrode, remove noise, and / or improve signal quality. At times, receiver / interface 145 may perform step 620.[000201] Optionally, in step 625, fetal heart rate data (e.g., beats per minute, trends over time, etc.) may be prepared using, for example, the ECG data of step 605 and / or the conditioned ECG data of step 620 may be determined or otherwise prepared. The fetal heart rate may be determined via any acceptable method including, but not limited to, performing R-wave detection and calculating a R-waveinterval measurement, determining a number of R waves / minute, determining a number of QRS complexes / minute, using a mean or average time between consecutive QRS complexes, determining a change in fetal heart rate overtime, using frequency analysis (e.g., fast Fourier transforms) to determine fetal heart rate, and / or determining a time-weighted average of fetal heart rate.[000202] In step 630, the fetal ECG data of step 605, the conditioned fetal ECG data of step 620, the fetal heart rate of step 625, and / or temperature data may then be provided to an output device, such as output and / or printout device 180. When temperature data is provided, it may be used by a clinician to, for example, diagnose infection.[000203] In some embodiments, method 600 may be executed using analog equipment and / or signals. In these embodiments, the ECG data of step 605 and / or the conditioned ECG data of step 620 may be directly received by a printout device like output and / or printout device 180 when output and / or printout device 180 is embodied as, for example, a strip chart recorder. The received ECG data may drive the printout device to generate a physical printout of the ECG data. In these embodiments, method 600 may only include steps 605, 620, and 630; with execution of step 620 being optional.[000204] For embodiments disclosed herein that include a plurality of ECG leads configured and / or positioned to be in contact with fetal skin, execution of method 600 may include selecting ECG data (including the reference signal) from one or more of the plurality of ECG leads based upon, for example, signal strength (e.g., amplitude and / or power), impedance, and / or clarity (e.g., high signal-to-noise ratio) for further analysis (e.g., execution of step(s) 625 and / or 630). This may be effective when, for example, one (or more) ECG lead(s) lifts off the fetal skin with another ECG lead remains in contact.[000205] FIG. 7 is a flowchart illustrating a method 700 for determining fetal-oximetry information (e.g., fetal tissue oxygenation and / or a level of oxygen saturation for fetal hemoglobin) using a direct-measurement-fetal-oximetry sensor such as direct-measurement-fetal-oximetry sensors disclosed herein (e.g., direct-measurement-fetal-oximetry sensor 115B, 200, 201, 202, 204, 301, 302, 303, 501, 502, or 503). Method 700 may be performed by, for example, any of the system(s) disclosed herein.[000206] Optionally, in step 705, information (e.g., a measurement) may be received from a contact sensor. The information received in step 705 may be receivedfrom, for example, the direct-measurement-fetal-oximetry sensor and / or a component thereof such as an ECG lead like ECG lead 144, a contact sensor like contact sensor 158, and / or a force / pressure sensor like force / pressure sensor 162.[000207] In step 710, it may be determined whether the information received in step 705 indicates that the direct-measurement-fetal-oximetry sensor, or an active surface thereof (e.g., active surface 230), is in, for example, physical, optical, and / or electrical contact with tissue (fetal or maternal) within the uterus of a pregnant mammal and, if not, an error message and / or a message instructing the user to, for example, adjust a position of direct-measurement-fetal-oximetry sensor to reestablish contact with fetal skin may be communicated to the user (step 745) via, for example, providing the error message to a output device like display device 155. When a result of the determination of step 710 indicates the direct-measurement-fetal-oximetry sensor, or the active surface thereof is in, for example, physical, optical, and / or electrical contact with tissue, method 700 proceeds to step 715.[000208] In some embodiments, the information received in step 705 is an impedance measurement (which may be measured by an ECG lead like ECG lead 144) and the determination of step 710 may include determining if a value of the impedance measurement is consistent with, for example, contact with fetal tissue, contact with maternal tissue, and / or contact with fluid, such as amniotic fluid. If the impedance measurement is consistent with contact with fetal tissue (e.g., 1,900-15,800 Ohms), method 700 may proceed to step 715. Alternatively, if the impedance measurement is consistent with contact with maternal tissue and / or fluid, method 700 may proceed to step 745. Additionally, or alternatively, when the contact sensor is embodied as a camera, execution of step 710 may include analysis of one or more image(s) generated by the camera to determine optical properties of the tissue of the image(s) to see if they are consistent with maternal (e.g., uterine) optical properties or fetal optical properties.[000209] Additionally, or alternatively, information and / or signals received from the source(s) and / or detector(s) of the direct-measurement-fetal-oximetry sensor may be used to sense whether a surface of the direct-measurement-fetal-oximetry sensor is in contact with maternal and / or fetal tissue. For example, one or more signal(s) from two or more of the detector(s) on active side 230 and / or maternal optical sensor side 232 may be used to determine an effective attenuation coefficient of the tissue being interrogated by light from the light source and detected by the detectors. It may thenbe determined whether or not the effective attenuation coefficient is consistent with maternal tissue (e.g., uterine wall) or fetal tissue (e.g., fetal skin). In some cases, an effective attenuation coefficient may be determined for tissue interrogated by the light source and detectors of both active side 230 and maternal optical sensor side 232. The two effective attenuation coefficients may then be compared with one another to, for example, determine differences therebetween and / or assess which side of the housing is facing fetal skin and which side of housing 205 is facing maternal tissue.[000210] Additionally, or alternatively, the information received in step 705 may be an image or video of the area in which the direct-measurement -fetal-oximetry sensor is positioned. In these embodiments, execution of step 710 may include evaluation of the image, or video, to see if it is consistent with contact with the fetus. In some embodiments, this evaluation may include color analysis to determine whether the image includes colors consistent with fetal skin, vernix, or maternal tissue (e.g., uterine wall or cervix).[000211] Additionally, or alternatively, the information received in step 705 may be a pressure and / or force measurement corresponding to pressure and / or force within an inflation line (e.g., inflation line 215) for an inflatable stabilization device (e.g., stabilization device 225) of a direct-measurement -fetal-oximetry sensor. A relatively high (e.g., 0.5-1.5 Ibf) pressure and / or force measurement may indicate that the stabilization device is experiencing back pressure and / or force from being wedged between the fetus and the pregnant mammal and, in these instances, method 700 may proceed to step 715. Alternatively, a relatively low pressure and / or force measurement a may indicate that the stabilization device is not experiencing back pressure from being wedged between the fetus and the pregnant mammal and, in these instances, it may be deduced that the direct-measurement -fetal-oximetry sensor is not in contact with fetal skin (e.g., is floating in the amniotic fluid) and method 700 may proceed to step 745. On some occasions, execution of step 745 may include providing an instruction to further inflate the stabilization device to the output device.[000212] In step 715, one or more signals may be received from the direct-measurement-fetal-oximetry sensor and / or a component thereof, such as one or more detectors like detector 160. The received signals may be responsive to light (e.g., between 600 and 1000nm) projected into the fetal skin by a light source of the direct-measurement-fetal-oximetry sensor such as one or more light source(s) 105 and maybe, for example, an optical signal, an analog signal, and / or an electronic signal corresponding to light detected by the detector.[000213] In some embodiments, the one or more received signals may be used to determine oximetry information (step 720) such as pulse oximetry information, fetal hemoglobin oxygen concentration, DC oxygen saturation levels, AC oxygen saturation levels, and / or tissue oxygen saturation levels. At times, execution of step 720 may include performing one or more calibrations using the one or more received signals. For example, information received in step 705 may be used to determine a skin tone and / or level of scattering and / or absorption by tissue and this / these determinations may be used to calibrate a determination of oximetry information as, for example, described herein.[000214] In some embodiments, the oximetry information may be determined in step 715 using, for example, the modified Beer-Lambert law, which is presented as Equation 1 below, for each wavelength of light included in the received signal(s) (step 710) under study.where:Apa(A) = the change in the absorption coefficient for a given wavelength A over a defined time period;r = a distance between the light source and detector;DPF = the differential path length factor for the given wavelength A;Io = the intensity of emitted light of the given wavelength A (e.g., the number of photons emitted by the light source) and time (t) = 0; andA / (A) = the change in the measured light intensity of detected light (e.g., the number of photons detected by the detector) for the given wavelength A over the defined time period.A value for Io for each wavelength of light in an incident optical signal corresponding to a received signal under study may be, for example, an intensity of light of the particular wavelength projected into the skin.[000215] Once the absorption coefficient is determined via Equation 1, oximetry information (e.g., an indication of hemoglobin oxygen saturation) may be determined via, for example, calculations using Equation 2, provided below:Apa(A)= AcHbO*sHbO(A)+AcHb*sHb (X) Equation 2where:Apa(A) = the change in the absorption coefficient for a given wavelength A over a defined time period;AcHbo = a change in the concentration of oxygenated hemoglobin (HbO) over the defined time period;AcHb = a change in the concentration of deoxygenated hemoglobin (Hb) over the defined time period;8Hbo(A) = the extinction coefficient for oxygenated hemoglobin (HbO) for the given wavelength; and8Hb(A) = the extinction coefficient for deoxygenated hemoglobin (Hb) for the given wavelength.[000216] Equation 1 may be solved for two or more wavelength pairs by inputting the change in intensity I, as a function of wavelength A. From this, changes in absorption coefficients, Apa, may be determined using Equation 2 by inputting known extinction coefficients, sHbO(A) and sHb (A) for a particular wavelength, which may be, for example, looked up in, for example, a look-up table stored on, for example, computer and / or processor 150 to determine, for example, a level of oxygen saturation for the blood. The wavelength pairs used to perform the calculations of Equation 2 may be any pair of wavelengths included in the spectrum of wavelengths of the optical signal incident upon the skin. In some embodiments, the calculation of Equation 2 may be performed many times (e.g., 10s, 100s, or 1000s), in different combinations of wavelengths, in order to arrive at multiple values for AcHbO and AcHb which may be weighted and / or averaged according to one or more criteria to arrive at robust values (e.g., statistically valid and / or with an acceptable level of confidence and error rate) for AcHbO and AcHb for the fetus. Additionally, or alternatively, the calculation of Equation 2 may be performed many times (e.g., 10s, 100s, or 1000s), to fit a plurality of wavelengths at the same time to the equation.[000217] The values for AcHbO and AcHb generated via Equation 2 may be relative values, not absolute values, for the concentrations of oxygenated anddeoxygenated hemoglobin in the fetus’s blood, which may be useful in monitoring changes in the hemoglobin oxygen saturation levels of the fetus over time as, for example, a determination of oximetry information. In some embodiments, the determination of step 715 may also include determining an overall oxygen saturation for the fetus’s hemoglobin by determining a ratio of the change in concentration of oxygenated hemoglobin to the change in concentration of total functional hemoglobin, which may be the sum of oxygenated and deoxygenated hemoglobin.[000218] In situations where the direct-measurement-fetal-oximetry sensor includes multiple detectors, each detector providing a signal received in step 710 may have a different source / detector distance and each detector may be associated with a different detector identifier (e.g., a code). These different detectors may each contribute a different signal to the signals received in step 710 and each of these signals may be associated with a respective detector identifier so that, for example, the source / detector distance for a particular received signal within a group or set of received signals may be determined and / or factored into the determination of the oximetry information of step 715.[000219] In some embodiments, the optical signal corresponding to one or more of the received signals, or a portion thereof, may be of a set, or known, wavelength that may be at an isosbestic point (e.g., 808 nm) for light directed into human tissue to determine a ratio of oxygenated and de-oxygenated hemoglobin for the human’s blood. Light at this wavelength is reflected from oxygenated and de-oxygenated hemoglobin in the same way and may be used to, for example, determine a skin tone of the fetus and / or level of absorption and / or scattering caused by the fetal skin / tissue using, for example, Equations 1 or 2 as explained herein.[000220] Optionally, in step 725, secondary information may be received from, for example, one or more components of system 100. For example, maternal pulse oximetry information, maternal tissue oximetry information, maternal heartrate, maternal ECG information, fetal heartrate, and / or a pressure and / or force within an inflation line (e.g., inflation line 215) may be received from one or more components of a system like system 100 and / or a direct-measurement-fetal-oximetry device like the direct-measurement-fetal-oximetry devices disclosed herein. In some cases, the secondary information received in step 725 is accelerometry, orientation, and / or motion information provided by accelerometer 169 and / or force and / or pressure information received from force / pressure sensor 162. Information regarding motion ofthe fetus and / or uterus used to remove motion artifacts from the signals received in step 715, wherein force / pressure sensor data and / or accelerometry data may be used to understand forces and / or pressure exerted on the fetus by, for example, uterine contractions and / or motion of the fetus that may interfere with, or otherwise confound, optical, or other signals, received in step 715.[000221] In step 730, the secondary information may be compared with the direct-measurement oximetry information to determine whether, or not, the direct-measurement oximetry information is fetal-oximetry information (or maternal-oximetry information) and, if not, step 745 may be executed. Execution of step 745 may include, for example, providing an error message, providing an instruction to further inflate a stabilization device of the direct-measurement-fetal-oximetry device to the output device, and / or providing an instruction to adjust a position and / or an orientation of the direct-measurement-fetal-oximetry device responsively to the indication of the determination. Following step 745, method 700 may end.[000222] In some embodiments, information from the contact sensor received in step 705 may include ECG information, and the secondary information received in step 725 may be maternal ECG information from an external maternal ECG monitor (e.g., ECG 175). In these embodiments, execution of step 735 may include comparing, or otherwise evaluating, the maternal ECG information and the ECG information from the contact sensor to determine whether the ECG information from the contact sensor approximately matches the maternal ECG information in terms of heartrate and, if not, it may be deduced that the ECG information from the contact sensor indicates that the contact sensor (and therefore the active side of the direct-measurement-fetal-oximetry device) is in contact with fetal skin. If the ECG information from the contact sensor matches the maternal ECG information, it may indicate that the contact sensor is contact with maternal (as opposed to fetal) tissue and method 700 may proceed to step 745.[000223] Additionally, or alternatively, information from the contact sensor received in step 705 may include ECG information and the secondary information received in step 725 may be fetal heartrate information from fetal heartrate monitor (e.g., Doppler / ultrasound sensor 135). In these embodiments, execution of step 735 may include determining heartrate information from the ECG information from the contact sensor and determining whether the heartrate information indicated by the ECG information from the contact sensor approximately matches the fetal heartrateinformation from the fetal heartrate monitor and, if so, it may be deduced that the ECG information from the contact sensor indicates that the contact sensor (and therefore the active side of the direct-measurement-fetal-oximetry device) is in contact with fetal skin. If the ECG / heartrate information from the contact sensor does not approximately match the fetal ECG information, it may indicate that the contact sensor is contact with maternal (as opposed to fetal) tissue and method 700 may proceed to step 745. If the ECG / heartrate information from the contact sensor does approximately match the fetal ECG information, it may indicate that the contact sensor is contact with fetal (as opposed to maternal) tissue and method 700 may proceed to step 740.[000224] Additionally, or alternatively, maternal tissue optical property information may be received from a maternal oximetry monitor (e.g., pulse oximetry sensor 130) during execution of step 725 and, in step 735 the maternal tissue optical property information may be compared with the signals (or oximetry information determined therefrom) from the direct-measurement-fetal-oximetry sensor. If the maternal oximetry approximately matches (e.g., within 1-20%) the oximetry information from the direct-measurement-fetal-oximetry device and it may be deduced that the oximetry information provided by the direct-measurement-fetal-oximetry device is maternal (and not fetal) oximetry information and method 700 may proceed to step 745. If the oximetry information from the direct-measurement-fetal-oximetry device does not approximately match the maternal tissue optical property information, it may indicate that the contact sensor is contact with fetal (as opposed to maternal) tissue and method 700 may proceed to step 740. Additionally, or alternatively, the maternal tissue optical property information may be used to calculate, or determine, maternal heartrate. This maternal heartrate may be compared a fetal ECG measurement and / or a fetal heartrate derived from a fetal SpO2 measurement by, for example, comparing a number of heart beats per minute for the maternal heartrate and the fetal ECG measurement and / or a fetal heartrate derived from a fetal SpO2 measurement, a shape of the R-wave , for the maternal heartrate and the fetal ECG measurement, and / or a when, in time, peaks of the R-wave are provided by both the for the maternal heartrate and the fetal ECG measurement.[000225] When the determination of step 735 indicates that the directly-measured oximetry information is fetal-oximetry information, method 700 may continue to step 740. In step 740, the fetal-oximetry information may be provided to a user via, for example, a output device (e.g., display device 155) and / or a user interface like userinterface 164 as, for example, a fetal hemoglobin oxygen saturation level or percentage, an AC fetal hemoglobin oxygen saturation level or percentage, a DC fetal hemoglobin oxygen saturation level or percentage, a fetal tissue oxygen saturation level or percentage, a binary value indicating whether or not the fetus is in distress (e.g., 1 for no distress and 2 for distress), and a scale (e.g., 1-10) indicating whether or not the fetus is in distress (e.g., 1 for no distress and 10 for extreme distress). In some embodiments, execution of step 740 may include providing an indication to the output device that the contact sensor is in electrical contact with fetal skin. At times, the directly-measured-fetal-oximetry information may be averaged over a period of time (e.g., 5, 10, 15, 20, 30, 40, 45, or 60 minutes) and when the directly-measured-fetal-oximetry information and / or a value indicating same falls below a threshold amount, a prediction that the fetus is in distress may be made and / or an alert may be provided to the output device.[000226] Optionally, in some embodiments, method 700 may be executed on multiple occasions over a period of time (e.g., minutes or hours) and over this period of time, it may optionally be determined and / or verified that the direct-measurement-fetal-oximetry sensor is still in contact with fetal skin (step 725). This determination / verification may be made using, for example, information received from an ECG lead like ECG lead 144, a contact sensor like contact sensor 158, and / or a force / pressure sensor like force / pressure sensor 162. Additionally, or alternatively, this determination / verification may be made by evaluating signal strength, wherein a direct-measurement-fetal-oximetry sensor may provide a weak signal when not in contact with the fetal skin. When direct-measurement-fetal-oximetry sensor is in contact with fetal skin, method 700 may proceed to step 710. When direct-measurement-fetal-oximetry sensor is not in contact with fetal skin, an error message and / or a message instructing the user to, for example, adjust a position of direct-measurement-fetal-oximetry sensor to reestablish contact with fetal skin may be communicated to the user (step 730). Additionally, or alternatively, execution of step 730 may include providing an instruction to the direct-measurement-fetal-oximetry sensor to take action to reestablish contact with the fetal skin by, for example, inflating a stabilizing device like stabilizing device 225.[000227] FIG. 8 illustrates an exemplary method 800 for using both a transabdominal-fetal-oximetry sensor and a direct-measurement-fetal-oximetry sensor to obtain, determine, and / or validate transabdominally-obtained-fetal-oximetryinformation using direct-measurement-fetal-oximetry information. Method 800 may be performed by, for example, any of the system(s) disclosed herein.[000228] In step 805, one or more signals (e.g., analog, digital, and / or electronic signals) corresponding to one or more respective optical signals emanating from a pregnant mammal and / or her fetus that have been detected by a detector like detector 160 may be received by, for example, a processor or computer and / or processor like computer and / or processor 150. The signals may be received from a transabdominal-fetal-oximetry sensor such as transabdominal-fetal-oximetry sensor 115A. Optionally, in step 810, secondary information such as one or more characteristics of the maternal tissue and / or the pregnant mammal’s fetus may be received from, for example, one or more components of system 100. Exemplary characteristics include, but are not limited to, a fetal depth (i.e., a width of tissue and / or amniotic fluid positioned between a detector of the transabdominal-fetal-oximetry sensor and the fetus), maternal tissue layer thicknesses, maternal heartrate, a maternal heartbeat signal, maternal pulse oximetry information, maternal DC oximetry information, a noise signal and / or a fetal heartbeat signal. Additionally, or alternatively, the secondary information received in step 810 is accelerometry, orientation, and / or motion information provided by, for example, accelerometer 169.[000229] Optionally, in step 815, the received signal(s) may be processed to isolate a portion thereof that was incident on the fetus that may be referred to herein as a “fetal signal.” Step 815 may be executed using any appropriate method of isolating a fetal signal from a corresponding received signal and / or set of received signals including, but not limited to, reducing noise in the signal(s) via, for example, application of filtering, noise cancellation, or amplification techniques, determining a portion of the first detected electronic signal that is contributed by the pregnant mammal and then subtracting, or otherwise removing, that portion of the first detected electronic signal from the received first detected electronic signals and / or receiving information regarding a fetal heartrate and using that information to lock in (via, for example, a lock-in amplifier) on a portion of the received first detected electronic signals generated by the fetus. In some embodiments, the direct-measurement-fetal-oximetry sensor may provide directly-measured-fetal-ECG information and / or a directly-measured-fetal-ECG signal and this ECG information / signal may be used to isolate the one or more fetal signals by, for example, providing assistance when selecting portions of the one or more signals received in step 805 to further analyzeand / or filtering portions of the one or more signals received in step 805 to remove portions that do not correspond to a fetal heartrate.[000230] Optionally, execution of step 815 may include pre-processing of the detected electronic signal in order to, for example, remove noise from the signal and / or confounding effects of the pregnant mammal’s anatomy or physiological signals (e.g., a respiratory signal) from the detected electronic signals. Execution of the preprocessing may include, but is not limited to, application of filtering techniques to the received signal(s), application of amplification techniques to the received signal(s), utilization of a lock-in amplifier on the received signal(s), and so on. In some embodiments, the pre-processing may include application of a filter (e.g., bandpass or Kalman) to the received signal(s) to reduce noise or hum in the received signal(s) that may be caused by, for example, electronic noise generated by equipment generating and / or detecting the received signal(s) and / or environmental equipment (e.g., a ventilator) that may, in some instances, be proximate and / or coupled to the pregnant mammal. Additionally, or alternatively, execution of step 815 may include removing motion artifacts from the one or more signals received in step 805. Information regarding motion of the fetus and / or uterus used to remove motion artifacts from the signals received in step 805 may be provided by, for example, accelerometer 169 and / or force / pressure sensor 162, wherein force / pressure sensor data and / or accelerometry data may be used to understand forces and / or pressure exerted on the fetus by, for example, uterine contractions and / or motion of the fetus that may interfere with, or otherwise confound, optical, or other signals, received in step 805.[000231] The fetal signal may then be used to determine transabdominally-obtained-fetal-oximetry information using, for example, Equations 1 and 2, described above (step 820). Next, steps 705, 710, and / or 715 of method 700 may be executed to determine fetal-oximetry information using one or more signals from a direct-measurement-fetal-oximetry sensor. Then, the transabdominally-obtained fetal-oximetry information (step 820) and the fetal-oximetry information determined using one or more signals from a direct-measurement-fetal-oximetry sensor (step 715) may be compared with one another or otherwise processed (step 825) to determine one or more differences therebetween. Then, in step 830, it may be determined whether the comparison results are within a specified range of values. Execution of step 830 may include, for example, determining whether the determined transabdominally-obtained-fetal-oximetry information and the direct-measurement-fetal-oximetry information (orvalues corresponding thereto) fall within a standard of deviation (e.g., + / - 1%, 3%, 5%, or 10%) or acceptable range of error when compared with one another. When the transabdominally-obtained-fetal-oximetry information and the direct-measurement-fetal-oximetry information are not within a specified range of values (e.g., are too different from one another), the results of the comparison may be analyzed to, for example, detect errors, determine a source of errors, or otherwise trouble shoot the determinations of the transabdominally-obtained-fetal-oximetry information and the direct-measurement-fetal-oximetry information (step 835). Additionally, or alternatively, execution of step 835 may include requesting and / or initiating a repeated execution of step(s) 805-820 and / or 705, 710, and / or 715 to determine subsequent transabdominally-obtained-fetal-oximetry information and / or direct-measurement-fetal-oximetry information. When the transabdominally-obtained-fetal-oximetry information and the direct-measurement-fetal-oximetry information values are within a specified range of values (i.e., not too different (e.g., within 1-10%) from one another), an indication of the fetal-oximetry information may be communicated to an output device for display or provision to a user (step 840).[000232] In some embodiments, data gathered from a direct-measurement-fetal-oximetry sensor may be used to set and / or adjust one or more hardware (e.g., beam focus, wavelengths and / or intensity of light used, selection of one or more detectors from a plurality of detectors to be used, etc.) and / or software (e.g., timing, multiplexing, duration of light beam projection, etc.) settings of a transabdominal-fetal-oximetry sensor on, for example, a one-time, periodic, as-needed (e.g., as a spot check) and / or continuous basis by, for example, executing some, or all, of method 900 as shown in FIG. 9, which may be executed by any of the systems, devices, and / or components thereof disclosed herein. Additionally, or alternatively, method 900, or a portion thereof, may be executed to calibrate and / or mathematically adjust one or more signals received from a transabdominal-fetal-oximetry sensor and / or the analysis of those signals. Execution method 900 may begin with performance of step(s) 705, 710, and / or 715.[000233] Optionally, in step 905, one or more settings and / or parameters for a transabdominal-fetal-oximetry sensor and / or a component thereof may be determined using, for example, the one or more directly-measured-fetal-oximetry signals received in step 710 and / or fetal-oximetry information determined in step 715. Exemplary settings and / or parameters for the transabdominal-fetal-oximetry sensor include, butare not limited to one or more wavelengths emitted by a light source of the transabdominal-fetal-oximetry sensor (e.g., light source 105), an intensity, focus, and / or incident angle of light projected into the pregnant mammal’s abdomen by a light source of the transabdominal-fetal-oximetry sensor, an optical multiplexing routine performed by the transabdominal-fetal-oximetry sensor or a component thereof, and a duty cycle (turning on and / or off) of one or more light sources and / or detectors included in the transabdominal-fetal-oximetry sensor. Additionally, or alternatively, a setting or parameter received and / or determined in step 905 may select one or more detectors (e.g., detector 160) from which to receive a signal, tune a sensitivity of a detector of the transabdominal-fetal-oximetry sensor to preferentially detect light of one or more wavelengths, selection or determination of a parameter for processing (e.g., noise reduction, filtration, and / or amplification) one or more signals generated by and / or transmitted from the transabdominal-fetal-oximetry sensor.[000234] In some embodiments, execution of step 905 may include processing the one or more directly-measured-fetal-oximetry signals received in step 710 and / or fetal-oximetry information determined in step 715 to determine optical scattering and / or absorption characteristics for the fetus, optimize a manner in which to project light (e.g., wavelength(s), intensity, multiplexing protocols, duty cycles, etc.) into the maternal abdomen, and / or optimize a manner in which to detect light reflected by the fetus (e.g., duty cycles, detector sensitivity, power draw, etc.) by a transabdominal-fetal-oximetry sensor.[000235] Additionally, or alternatively, in some embodiments, step 920 (receiving secondary information) may be executed prior to step 905 and, in these embodiments, execution of step 905 may include analysis of the secondary information to determine the one or more parameters and / or settings for the transabdominal-fetal-oximetry sensor. For example, secondary information in the form of one or more optical, anatomical, and / or geometrical properties of the fetus and / or pregnant mammal that may be received from, for example, Doppler / ultrasound sensor 165, ECG 175, and / or database 170 and / or determined using the one or more directly-measured-fetal-oximetry signals received in step 710 and / or fetal-oximetry information determined in step 715 may be used to set and / or adjust a parameter and / or setting for the transabdominal-fetal-oximetry sensor. For example, an intensity of light projected by a light source of the transabdominal-fetal-oximetry sensor may be adjusted responsively to a fetal depth (e.g., a distance between the pregnant mammalsepidermis and the fetus’ epidermis) and / or a multiplexing routine (e.g., emitting light of different wavelengths at different times) performed by the transabdominal-fetal-oximetry sensor may be adjusted responsively to a fetal depth, a presence of meconium in the amniotic fluid, and / or skin color.[000236] When step 905 is performed, in step 910, the transabdominal-fetal-oximetry sensor and / or an operation thereof may be adjusted according to one or more determinations of step 905.[000237] In step 915, one or more signals corresponding to one or more respective optical signals emanating from a pregnant mammal and / or her fetus may be received by, for example, a processor or computer and / or processor like computer and / or processor 150. The one or more signals may be received from a transabdominal-fetal-oximetry sensor such as transabdominal-fetal-oximetry sensor 115A that, in some embodiments, may be adjusted via execution of step 910.[000238] Optionally, in step 920, secondary information such as the secondary information described above with regard to execution of step 810, may be received. Optionally, in step 925, the received signal(s) of step 915 may be processed to isolate a portion thereof that was incident on the fetus, thereby generating one or more adjusted fetal signal(s). Optionally, execution of step 920 may include using the secondary information to filter, amplify, and / or reduce noise in the signals received in step 915. In some embodiments, execution of step 925 may be similar to execution of step 815, described above with the exception that the transabdominal-fetal-oximetry sensor providing the one or more signals of step 915 may be adjusted in, for example, steps 910 and / or 915. Additionally, or alternatively, the one or more signals received from the direct-measurement-fetal-oximetry sensor may be used, in a manner similar to that described above with regard to step 815, to isolate and / or generate the fetal signal during execution of step 925.[000239] In step 930, transabdominally-obtained-fetal-oximetry information may be determined using the fetal signals of step 925 as, for example, described herein (e.g., using, for example, Equations 1 or 2 as explained herein). Then, in step 935, the transabdominally-obtained-fetal-oximetry information from step 930 and the direct-measurement-fetal-oximetry information of step 715 may be compared with one another or otherwise processed to determine one or more differences therebetween. Then, in step 940, it may be determined whether the comparison results are within a specified range of values (e.g., within a standard of deviation or within 5-20%, 1-10%,5-10%, 1-5%, 1-20% of each other). In some embodiments, execution of step 940 may be similar to execution of step 830, described above. When the adjusted transabdominally-obtained-fetal-oximetry information and the direct-measurement-fetal-oximetry information values are within the specified range of values, an indication of the transabdominally-obtained-fetal-oximetry information may be communicated to, for example, an output device for display or provision to a user (step 950).[000240] In some embodiments, the secondary information received in step 920 may be maternal tissue optical property information received from a set of maternal optical sensors like the set of maternal optical sensors of direct-measurement-fetal-oximetry sensor 204. The maternal tissue optical property information received from the set of maternal optical sensors may include, for example, tissue oximetry information for maternal tissue positioned between a direct-measurement-fetal-oximetry sensor like the direct-measurement-fetal-oximetry sensors disclosed herein, optical characteristics (e.g., scattering and / or absorption) of the maternal tissue positioned proximate to the direct-measurement-fetal-oximetry sensor overlying the fetus, and / or a thickness of maternal tissue proximate to direct-measurement-fetal-oximetry sensor by, for example, measuring a time of flight for light (i.e., photons) from when they are emitted by a light source (e.g., source 105) and detected by a detector (e.g., detector 160). Additionally, or alternatively, secondary information received in step 920 may be a fetal depth that is measured and / or deduced using one or more images (e.g., ultrasound images) of a maternal abdomen. For example, when the direct-measurement-fetal-oximetry sensor providing the signals of step 715 includes a marker like marker 207, a fetal depth may be determined using ultrasound images of the maternal abdomen and, for example, measuring a distance between marker 207 and the maternal epidermis as shown in one or more ultrasound images.[000241] When maternal tissue optical property information is received from the set of maternal optical sensors in step 920, the maternal tissue optical property information may be used during execution of step 925 to generate the one or more fetal signal(s) and / or isolate maternal and fetal contributions to one or more signals from a transabdominal-fetal-oximetry sensor like the transabdominal-fetal-oximetry sensors disclosed herein. Additionally, or alternatively, when maternal tissue optical property information is received from the set of maternal optical sensors in step 920, execution of step 930 to determine fetal oximetry information may be executed by, forexample, calibrating the fetal oximetry calculations to include and / or account for maternal optical characteristics and / or tissue oxygenation proximate to the fetus.[000242] Additionally, or alternatively, when fetal depth information (or images from which fetal depth may be determined) are received in step 920, the fetal depth information may be used during execution of step 925 to generate the one or more fetal signal(s) and / or isolate maternal and fetal contributions to one or more signals from a transabdominal-fetal-oximetry sensor like the transabdominal-fetal-oximetry sensors disclosed herein. Additionally, or alternatively, when fetal depth information is received in step 920, execution of step 930 to determine fetal oximetry information may be executed by, for example, calibrating the fetal oximetry calculations to include and / or account for the fetal depth.[000243] In some embodiments, information received in step 920 may include fetal depth, maternal tissue composition, and / or maternal tissue layer thicknesses and / or the parameters determined in step 905 may be responsive to fetal depth, maternal tissue composition, and / or maternal tissue layer thicknesses. When the transabdominal-fetal-oximetry sensor has multiple light sources and / or multiple detectors, execution of step 910 and / or 925 may include selecting (using, for example, the fetal depth, maternal tissue composition, and / or maternal tissue layer thicknesses) one or more light source and detector pair(s) for signal extraction and / or analysis to generate the fetal signals. For example, if the transabdominal-fetal-oximetry sensor has once light source and six detectors like transabdominal-fetal-oximetry sensor 115A, each source detector pair may generate a signal and the fetal depth may be used to select which of these signals to generate the fetal signal. Continuing with the example of transabdominal-fetal-oximetry sensor 115A only the signals from detectors 160C, 160D, 160E, and 160F would be selected for further processing and / or generation of the fetal signal because the signals from detectors 160A and 160B do not penetrate the abdominal tissue to the fetal depth (i.e., are not incident on the fetus). Additionally, or alternatively, fetal depth, maternal tissue composition, and / or maternal tissue layer thicknesses may be used to select one or more wavelengths of light projected by the light source into the maternal abdomen. Additionally, or alternatively, maternal optical properties may be received in step 920 and these maternal optical properties may be used to adjust[000244] Additionally, or alternatively, execution of method 900 (e.g., step 905, 910, 925, and / or 930) may include adjusting fetal oximetry calculations to incorporatemeasured maternal layer optical properties (e.g., peff) depending on, for example, fetal depth and / or maternal layer thicknesses.[000245] When the transabdominally-obtained and direct-measurement-fetal-oximetry information are not within a specified range of values (step 940), the results of the comparison may be analyzed to, for example, detect errors, determine a source of errors, or otherwise trouble shoot the determinations of the transabdominally-obtained-fetal-oximetry information to determine how to adjust the transabdominal-fetal-oximetry sensor (step 945) and some, or all of, step(s) 905-945 may be repeated.[000246] FIG. 10 illustrates a method 1000 for calibrating one or more signals received from a transabdominal-fetal-oximetry sensor, which may be executed by any of the systems, devices, and / or components thereof disclosed herein. Execution method 1000 may begin with performance of step(s) 705, 710, and 715.[000247] In step 1005, one or more signals (e.g., digital and / or analog) corresponding to one or more respective optical signals emanating from a pregnant mammal and / or her fetus may be received by, for example, a processor or computer and / or processor like computer and / or processor 150. The one or more signals may be received from a transabdominal-fetal-oximetry sensor such as transabdominal-fetal-oximetry sensor 115A that, in some embodiments, may be adjusted via, for example, execution of method 900 and / or a detector like detector 160.[000248] In step 1010, one or more calibrations, values, equations, coefficients, and / or algorithms, (at times collectively referred to as “calibrations” herein) to be applied to the signal(s) received in step 1005 may be determined and / or selected. These calibrations, values, equations, coefficients, and / or algorithms, correct, adjust, and / or pertain to scattering and / or absorption of maternal and / or fetal tissue, known errors or fluctuations in equipment performance (e.g., hum or distortion) that may impact one or more aspects of a signal, maternal and / or fetal geometry, anatomy, physiology, and / or tissue composition, and / or environmental factors that may impact the signal such as ambient light and / or electrical interference. In some embodiments, execution of step 1010 may incorporate determining one or more calibrations, values, equations, coefficients, and / or algorithms using information from a set of maternal optical sensors like the set of maternal optical sensors of direct-measurement-fetal-oximetry device 204.[000249] In step 1015, the one or more signal(s) received in step 1005 may be calibrated, or otherwise adjusted, using, for example, and / or one or more calibrations,values, equations, coefficients, and / or algorithms determined and / or selected in step 1010. Optionally, in step 1020, secondary information such as the secondary information described above with regard to execution of step 810 and 920, may be received.[000250] In some embodiments, step 1020 may be performed prior to performance of step 1010 and, in these embodiments, the determination and / or selection of the calibrations, values, equations, coefficients, and / or algorithms may be responsive to the secondary information. For example, if a maternal skin tone is received as secondary information, the maternal skin tone may be used, in step 1015 to calibrate, or otherwise adjust, the received signal(s) for optical properties (e.g., scattering and / or absorption) associated with the maternal skin tone.[000251] Then, in step 1025, the calibrated signal(s) of step 1015 may be processed using, for example, the secondary information of step 1020, to isolate a portion thereof that was incident on the fetus, thereby generating one or more calibrated fetal signal(s). Execution of step 1025 may be similar to execution of step 815 and / or 925, described above with the exception that the one or more signals may be calibrated in, for example, step 1015. Additionally, or alternatively, the one or more signals received from the direct-measurement-fetal-oximetry sensor may be used to isolate and / or generate the fetal signal during execution of step 1025.[000252] In step 1030, calibrated transabdominally-obtained-fetal-oximetry information may be determined using the calibrated signal(s) of step 1015 and / or the calibrated fetal signal(s) of step 1025 using one or more processes for determining fetal oximetry information described herein. In some embodiments, execution of step(s) 1020, 1025, and / or 1030 may be similar to and / or incorporate execution of some of the processes and / or steps of execution of step(s) 920, 925, and / or 930, respectively.[000253] In step 1035, the calibrated transabdominally-obtained-fetal-oximetry information from step 1030 and the direct-measurement-fetal-oximetry information of step 715 from method 700 may be compared with one another or otherwise processed to determine one or more differences therebetween. Next, in step 1040, it may be determined whether the comparison results are within a specified range of values (e.g., within a standard of deviation or within 5-20% of each other). In some embodiments, execution of step 1040 may be similar to execution of step 830 and / or 940, described above. When the calibrated transabdominally-obtained-fetal-oximetryinformation and the direct-measurement-fetal-oximetry information values are within a specified range of values (e.g., within a standard of deviation or within 5-20%, 1-10%, 5-10%, 1-5%, 1-20% of each other) and an indication of the calibrated transabdominally-obtained-fetal-oximetry information may be communicated to, for example, a output device for display or provision to a user (step 1050).[000254] When the calibrated transabdominally-obtained and direct-measurement-fetal-oximetry information are not within a specified range of values (step 1040), the results of the comparison may be analyzed to, for example, detect errors, determine a source of errors, or otherwise trouble shoot the determinations of the calibrated transabdominally-obtained-fetal-oximetry information to determine how to calibrate the transabdominally-obtained-fetal-oximetry signals (step 1045) and, in some instances, some, or all of, step(s) 1005-1045 may be repeated.[000255] FIG. 11 illustrates an exemplary method 1100 for validating transabdominally-obtained-fetal-oximetry information using direct-measurement-fetal-oximetry information. Method 1100 may be performed by, for example, any of the system(s) disclosed herein.[000256] In step 1105, direct-measurement-fetal-oximetry information, such as the direct-measurement-fetal-oximetry information determined in step 715 may be received and in step 1110, one or more signals corresponding to one or more respective optical signals emanating from a pregnant mammal and / or her fetus may be received by, for example, a processor or computer and / or processor like computer and / or processor 150. The one or more signals may be received from a transabdominal-fetal-oximetry sensor such as transabdominal-fetal-oximetry sensor 115A.[000257] Optionally, in step 1115, secondary information such as the secondary information described above with regard to, for example, execution of step(s) 810 and / or 920, may be received. Optionally, in step 1120, the signal(s) in step 1110 may be processed to isolate a portion thereof that was incident on the fetus, thereby generating one or more fetal signal(s). Execution of step(s) 1115 may be similar to, for example, execution of step(s) 820, 920, and / or 1020. Additionally, or alternatively, execution of step(s) 1120 may be similar to, for example, execution of step(s) 815, 925, and / or 1025.[000258] In step 1125, transabdominally-obtained-fetal-oximetry information may be determined using the one or more signals received in step 1110 and / or thetransabdominal fetal signals of step 1120. On some occasions, execution of step 1125 may resemble execution of step 930.[000259] Then, in step 1130, the transabdominally-obtained-fetal-oximetry information and the direct-measurement-fetal-oximetry information received in step 1105 may be compared with one another or otherwise processed (step 1130) to determine one or more differences therebetween. Then, in step 1135, it may be determined whether the comparison results are within a specified range of values (e.g., within a standard of deviation or within 5-20%, 1-10%, 5-10%, 1-5%, 1-20% of each other). Execution of step 1135 may be similar to execution of step 830, 940, and / or 1040, described above. When the transabdominally-obtained-fetal-oximetry information and the direct-measurement-fetal-oximetry information values are within a specified range of values, an indication of the transabdominally-obtained-fetal-oximetry information may be communicated to an output device for display or provision to a user (step 1145).[000260] When the calibrated transabdominally-obtained and direct-measurement-fetal-oximetry information are not within a specified range of values (step 1135), the results of the comparison may be analyzed to, for example, detect errors, determine a source of errors, or otherwise trouble shoot the determinations of the transabdominally-obtained-fetal-oximetry information and the direct-measurement-fetal-oximetry information to determine how to recalibrate the transabdominal-fetal-oximetry sensor, the signals received from the transabdominal-fetal-oximetry sensor, and / or calculations made using one or more signals received from the transabdominal-fetal-oximetry sensor (step 1140) so that step 1110, 1120, and / or 1125 may be repeated to accordingly recalibrate signals received from the transabdominal-fetal-oximetry sensor, the transabdominal fetal signals, and / or the determination of transabdominally-obtained-fetal oximetry information to, for example, more closely match the direct-measurement-fetal-oximetry information received in step 1105.[000261] FIG. 12 provides a flowchart illustrating an exemplary method 1200 for selecting a fetal heart rate signal from a plurality of fetal heart rate signals for provision to an output device and / or user. Method 1200 may be performed by, for example, any of the system(s) and / or system components disclosed herein.[000262] In step 1205, a plurality of signals from a fetal ECG sensor like the fetal ECG sensors disclosed herein and / or a plurality of signals from a fetal oximetry sensorlike the transabdominal and / or direct-measurement-fetal oximetry sensors disclosed herein may be received. Each of the received signals may be analyzed and / or processed to determine a respective plurality of fetal heart rate signals (step 1210). Additionally, or alternatively, in some embodiments, one or more fetal heart rate signals may be received in step 1205 and, in these embodiments, step 1210 may not be executed.[000263] In step 1215, the fetal heart rate signals may be analyzed and / or compared with one another to, for example, arbitrate between fetal heart rate signals and / or determine which fetal heart rate signal of the plurality is, for example, the most accurate, clear (e.g., high SNR), and / or has highest intensity or power and one or more of the fetal heart rate signals may be selected (step 1220) for provision to a output device (1225). In some embodiments, execution of step 1215 may include execution of one or more of a pattern recognition process, a noise cancelling process, a filtration process, an amplification process, an arbitration process, a linear combination process, a non-linear combination process, and / or a peak detection process.[000264] In some embodiments, execution of step 1215 and / or 1220 may include using two or more fetal heart rate signals to generate a more accurate composite fetal heart rate signal. This may be done by, for example, averaging two or more fetal heart rate signals, using a first fetal heart rate signal to filter and / or amplify a second fetal heart rate signal, and / or multiplying two or more fetal heart rate signals together. Execution of method 1200 may be particularly helpful in a labor and delivery suite of a hospital where obtaining an accurate and sufficiently loud fetal heart rate can be challenging due to, for example, the noise of the hospital, movement of the fetus within the uterus, and / or movement of traditionally used Doppler ultrasound pucks positioned on the abdomen of a pregnant mammal during labor and delivery of the fetus.[000265] FIG. 13 provides a flowchart illustrating an exemplary method 1300 for generating a validated fetal heart rate signal and optionally using the validated fetal heart rate signal determine fetal oximetry information. Method 1300 may be performed by, for example, any of the system(s) and / or system components disclosed herein.[000266] In step 1305, a fetal ECG signal and a Doppler ultrasound signal may be received and used to generate an ECG-derived fetal heart rate signal and a Doppler-derived fetal heart rate signal, respectively. The ECG-derived fetal heart rate signal and Doppler-derived fetal heart rate signal may be synchronized in time (step1310) and the synchronized ECG-derived fetal heart rate signal and Doppler-derived fetal heart rate signal may then be used to generate validated fetal heart rate information and / or a validated fetal heart rate signal (step 1315), which may be provided to a user via, for example, a display device (step 1320). Execution of step 1315 may include, but is not limited to, averaging the synchronized ECG-derived fetal heart rate signal and Doppler-derived fetal heart rate signal, using the synchronized ECG-derived fetal heart rate signal to filter and / or amplify the Doppler-derived fetal heart rate signal and vice versa, and / or multiplying the synchronized ECG-derived fetal heart rate signal and Doppler-derived fetal heart rate signal together.[000267] Optionally, in step 1325, one or more optical oximetry signals may be received from, for example, one or more of the transabdominal and / or direct-measurement-fetal-oximetry sensors disclosed herein. The optical oximetry signals and the validated fetal heart rate information may then be used to determine fetal oximetry information as, for example, described herein (step 1330). The fetal oximetry information may then be provided to an output device (step 1335).[000268] FIG. 14 provides a flowchart illustrating an exemplary method 1400 for determining fetal heart rate and fetal oximetry information and using fetal heart rate signal quality as a proxy for fetal oximetry determination quality, wherein if the same device measures fetal ECG signals and fetal oximetry information, if the fetal ECG signal is of sufficient quality to be clinically valid / actionable, it may be assumed and / or extrapolated to indicate that the fetal oximetry information is also of sufficient quality to be clinically valid / actionable. Method 1400 may be performed by, for example, any of the system(s) and / or system components disclosed herein.[000269] In step 1405, fetal oximetry and fetal ECG information may be received from one or more sensors. Often times, the information received in step 1405 is received from a combined fetal ECG and direct-measurement-fetal-oximetry sensor like the combined fetal ECG and direct-measurement-fetal-oximetry sensors disclosed herein. In step 1410, a quality indication, SNR, and / or category (e.g., 1, 2, or 3) for the fetal ECG signal(s) may be determined and, in step 1415, fetal oximetry information may be determined using the fetal oximetry signals received in step 1405 as, for example, described herein.[000270] In step 1420, it may be determined whether the quality of the fetal ECG signal determined in step 1410 is above a threshold and, if so, the fetal oximetry information determined via execution of step 1415 may be provided to an outputdevice (step 1425). Optionally, execution of step 1425 may include providing an indication of the fetal ECG signal and / or fetal ECG signal quality / category. When the quality of the fetal ECG signal determined in step 1410 is below the threshold (step 1420), method 1400 may proceed to step 1430, wherein the fetal oximetry information determined via execution of step 1415 may be provided to an output device along with an optional indication of fetal ECG signal quality / category or method 1400 may end (step 1435).[000271] FIG. 15 provides a flowchart illustrating an exemplary method 1500 for using optical fetal oximetry information and fetal ECG information to determine fetal heart rate. Method 1500 may be performed by, for example, any of the system(s) and / or system components disclosed herein.[000272] In step 1505, one or more fetal oximetry signal(s), fetal ECG signal(s), and / or Doppler ultrasound signal(s) may be received from, for example, one or more of a combined fetal ECG and direct-measurement-fetal-oximetry sensor like the combined fetal ECG and direct-measurement-fetal-oximetry sensors disclosed herein, a Doppler ultrasound device positioned on a pregnant mammal’s abdomen, a direct-measurement-fetal oximetry device like the direct-measurement-fetal oximetry devices disclosed herein, a transabdominal fetal oximetry device like the transabdominal fetal oximetry devices disclosed herein, and / or a fetal ECG device like the fetal ECG devices disclosed herein.[000273] Then the fetal oximetry signal(s) may be used to generate a first fetal heart rate signal (step 1510); the fetal ECG signal(s) may be used to generate a second fetal heart rate signal (step 1515); and, optionally, the Doppler ultrasound signal(s) may be used to generate a third fetal heart rate signal (step 1520). In step 1525, the first, second, and / or third fetal heart rate signals may be synchronized in time and used to generate validated fetal heart rate information (step 1530). The validated fetal heart rate information may then be provided to an output device (step 1535).[000274] FIG. 16 provides a flowchart illustrating an exemplary method 1600 for determining an indication of fetal health. Method 1600 may be performed by, for example, any of the system(s) and / or system components disclosed herein.[000275] In step 1605, one or more fetal oximetry signal(s) and fetal ECG signal(s) may be received from, for example, one or more of a combined fetal ECG and direct-measurement-fetal-oximetry sensor like the combined fetal ECG and direct-measurement-fetal-oximetry sensors disclosed herein, a direct-measurement-fetal oximetry device like the direct-measurement-fetal oximetry devices disclosed herein, a transabdominal fetal oximetry device like the transabdominal fetal oximetry devices disclosed herein, and / or a fetal ECG device like the fetal ECG devices disclosed herein. In step 1610, the signals received in step 1605 may be synchronized in time and used to determine fetal oximetry information (step 1615) as, for example, described herein. In step 1620, ST segment analysis may be performed on the received fetal ECG signal and a result of the ST segment analysis as well as the fetal oximetry information may be analyzed (step 1626) to determine an indication of fetal health (step 1630), which may be provided to an output device (step 1630). In some embodiments, the ST segment analysis of step 1620 may be executed to determine if the ST segment of the ECG signal(s) indicate fetal cardiac issues like cardiac, or myocardial, ischemia, which may, by proxy, indicate ischemia in the fetus’ brain and / or central nervous system because, an indication that the fetuses heart is experiencing ischemia may indicate the fetus is in distress and / or at risk for brain and / or central nervous system ischemia. In this way, an indication of cardiac ischemia combined with a low fetal oximetry value may strongly (e.g., high confidence) indicate that the fetus is in distress and / or at risk of neurological injury due to ischemia and / or acidosis.[000276] FIG. 17 provides a flowchart showing an exemplary method 1700 for developing, generating, updating, and / or building a model to determine and / or predict fetal wellness. Method 1700 may be executed by, for example, any of the systems disclosed herein and / or components thereof.[000277] Initially, in step 1705, a set of correlated fetal oximetry information and / or signal(s), fetal ECG information and / or signal(s), and fetal health information may be received. In some embodiments, the fetal oximetry and / or fetal ECG information and / or signal(s) may be a signal from a moment in time (e.g., a snapshot) and / or measured and / or recorded over a period of time (e.g., minutes or hours) of continuous, periodic, and / or as-needed monitoring prior to and / or during, for example, gestation and / or labor and delivery of the fetus. Additionally, or alternatively, the fetal oximetry and / or fetal ECG information and / or signal(s) received in step 1705 may indicate and / or include changes in the fetal oximetry and / or fetal ECG information and / or signal(s) over time (e.g., trends or rapid / sudden changes) and / or an analysis of the fetal oximetry and / or fetal ECG information and / or signal(s). Exemplary fetal health information includes, but is not limited to, Apgar scores following birth, umbilical cordmetabolic acidosis, base deficit, and / or an analysis of the fetal oximetry and / or fetal ECG information, which may include analysis of variations of the fetal oximetry and / or fetal ECG information over time and / or fetal ECG ST analysis.[000278] The set of correlated fetal oximetry, fetal ECG, and fetal health information may include a plurality (e.g., 10,000; 50,000; 500,000; 1,000,000;5,000,000) of sets of correlated fetal oximetry, fetal ECG, and fetal health information. The set of correlated fetal oximetry, fetal ECG, and fetal health information may be divided into a training set and a testing set (step 1710).[000279] Optionally, in step 1715, inputs to the machine learning architecture and / or software program for determining and / or predicting fetal health may be selected. Exemplary inputs include, but are not limited to, fetal depth, fetal heart rate, maternal heart rate, equipment characteristics, background noise characteristics, maternal geometrical characteristics, maternal physiological characteristics, fetal geometrical characteristics, fetal physiological characteristics and / or maternal oximetry values (e.g., SpO2). In some embodiments, one or more inputs may be received from a component of system 100 such as ECG 175, Doppler / ultrasound probe 135, and / or fetal oximetry sensor 115. In some embodiments, input features may be normalized to standard mean and / or variance values, such as zero mean and unit variance, and, in some instances, may be combined into composite features that are then input into the machine learning architecture. In some cases, the machine learning architecture disclosed herein may be a deep learning network architecture that may include convolutional nets and engineered feature layers.Additionally, or alternatively, the machine learning architecture may be a neural network, an artificial neural network, a Bayesian network, and / or software or hardware that utilizes artificial intelligence. In some embodiments, execution of step 1715 may include downsampling and / or activating one or convolutional layers of the machine learning architecture and / or a model (e.g., a simulated fetal oximetry model) generated by the machine learning architecture. In some cases, execution of step 1715 may also include adding one or more engineered features, bias, and / or classifier layers to the machine learning architecture and / or a model (e.g., a simulated fetal oximetry model) generated by the machine learning architecture. Additionally, or alternatively, models (e.g., simulated fetal oximetry models) generated by method 1700 may include tree-based models or ensembles of layered and / or tree-based models. Additionally, or alternatively, models generated bymethod 1700 may incorporate K-fold cross-validation to, for example, generate the expected error, receiver operating characteristic (ROC), and / or area under the curve (AUC) values for the model.[000280] In some embodiments, execution of step 1715 may include selection of one or more types of outputs that may be incorporated into the machine learning architecture. Exemplary outputs include predicted fetal health prediction that may include, for example, an indication that the fetus is distress or is not in distress, an indication that the fetus is experiencing fetal hypoxia, fetal hypoxemia, fetal nonhypoxia, and / or fetal non-hypoxemia and / or an indication of the confidence for the prediction. The training set may then be input into the machine learning architecture and a first version of a fetal health model may be generated (step 1720). The first version of the fetal health model may be configured to receive fetal oximetry and / or fetal ECG information and predict an indication of fetal health. The first version of the fetal health model may include a plurality of layers and / or functions and, in some cases, may include one or more small-layered network(s), sub-networks, and / or a Support Vector Machine. In some embodiments, execution of step 1720 may include communication of the machine learning inputs and / or machine learning architecture to, for example, a machine learning computer platform and / or neural network such as a machine learning platform resident on / within ML / AI platform 11. In some embodiments, execution of step 1720 may include storing the first version of the fetal health model in a database such as database 12.[000281] In step 1725, the first version of the fetal health model and / or a first set of outputs from the first version of the fetal health model may be tested using, for example, the testing data set from step 1710. The results of the testing may then be analyzed and evaluated and used to modify, update, and / or iterate upon the first version of the fetal health model thereby generating a second version of the fetal health model (step 1730) via, for example, training and / or tuning the first version of the fetal health model using the machine learning architecture and / or outputs of the first and / or second version of the fetal health model. In step 1735, the second (or a further iterated upon / updated version) of the fetal health model may be finalized and / or published for use.[000282] FIG. 18 provides a flowchart showing an exemplary method 1800 for using a fetal health model to determine and / or predict fetal wellness. Method 1800may be executed by, for example, any of the systems disclosed herein and / or components thereof.[000283] Initially, fetal oximetry and / or fetal ECG information and / or signal(s) may be received (step 1805). In some embodiments, the fetal oximetry and / or fetal ECG information and / or signal(s) may be received over time during, for example, continuous or periodic monitoring of a fetus and / or pregnant mammal as may occur during labor and delivery. Additionally, or alternatively, the fetal oximetry and / or fetal ECG information and / or signal(s) received in step 1805 may indicate and / or include changes in the fetal oximetry and / or fetal ECG information and / or signal(s) over time (e.g., trends or rapid / sudden changes) and / or an analysis of the fetal oximetry and / or fetal ECG information and / or signal(s).[000284] Optionally, the fetal oximetry and / or fetal ECG information and / or signal(s) may be synchronized in time (step 1810). In step 1815, the fetal oximetry and / or fetal ECG information and / or signal(s) and / or synchronized (when step 1810 is performed) fetal oximetry and / or fetal ECG information and / or signal(s) may be input into a fetal health model like the fetal health model of method 1700 and / or the finalized and / or published version of the fetal health model of step 1735. Optionally, execution of step 1815 may include inputting additional information about the pregnant mammal and / or fetus into the fetal health model. Exemplary additional information includes, but is not limited to, optical properties (e.g., scattering and / or absorption) of the pregnant mammal or fetuses tissue, geometrical properties of pregnant mammal and / or fetus, where on the body of the fetus the fetal oximetry and / or fetal ECG information and / or signal(s) were measured and / or obtained, fetal skin tone or melanin content, labor station, maternal and / or fetal heart rate, maternal hemoglobin oxygen saturation rate, length of labor to deliver the fetus and information (e.g., strength, duration, frequency) regarding uterine contractions.[000285] In step 1820, an output from the fetal health model may be received and provided to an output device (step 1830). Optionally, in step 1825, an indication of fetal health may be determined using the output of step 1820 prior to execution of step 1830. Exemplary outputs of the model (step 1820) and / or indications of fetal health (step 1825) include, but are not limited to, a binary value indicating whether or not the fetus is in distress (e.g., 1 for no distress and 2 for distress), and a scale (e.g., 1-10) indicating whether or not the fetus is in distress (e.g., 1 for no distress and 10 for extreme distress).[000286] FIG. 19 provides a flowchart illustrating an exemplary method 1900 for determining fetal oximetry information. Method 1900 may be performed by, for example, any of the system(s) and / or system components disclosed herein.[000287] In step 1905, a Doppler ultrasound signal may be received and used to generate a fetal heart rate and / or fetal heartbeat signal (step 1910), which may be optionally provided to a user via, for example, a display device (step 1915). In step 1920, one or more optical oximetry signals may be received from, for example, one or more of the transabdominal and / or direct-measurement-fetal-oximetry sensors disclosed herein. The optical oximetry signals and the fetal heart rate and / or fetal heartbeat information may then be used to determine fetal oximetry information as, for example, described herein (step 1925). The fetal oximetry information may then be provided to a display device (step 1930).[000288] FIG. 20 is a block diagram illustrating an exemplary system 10 for developing and / or using a model like a fetal health model according to one or more methods disclosed herein. System 10 includes a machine learning, networked computing, and / or artificial intelligence (AI / ML) platform 11 (hereinafter referred to as “AI / ML platform 11”), a database 12 in communication with AI / ML platform 11, a communication network 20, a computer 31, a local database 32, and an output device 33, which may be a device configured to receive and / or process an output (e.g., a computer or monitoring machine) and / or a display device (e.g., touch screen, one or more lights, one or more speakers, and / or a computer display, etc.). In many instances, communication network 20 is the Internet. The components of system 10 may be coupled together via wired and / or wireless communication links. In some instances, wireless communication of one or more components of system 10 may be enabled using short-range wireless communication protocols designed to communicate over relatively short distances (e.g., BLUETOOTH®, near field communication (NFC), radio-frequency identification (RFID), and Wi-Fi) with, for example, a computer or personal electronic device (e.g., tablet computer or smart phone) as described below. In some embodiments, AI / ML platform 11 may operate independently of one or more components of system 10. For example, AI / ML platform 11 may not be in communication with output device 33, local database 32, and / or communication network 20. In these embodiments, AI / ML platform 11 may communicate with computer 31 via a wired and / or wireless connection that may, or may not, be facilitated by communication network 20. Additionally, or alternatively,some of the components of system 10 may be resident within and / or communicatively coupled to a cloud computing and / or storage environment via, for example, a wired and / or wireless communication coupling that, in some cases, may be facilitated and / or provided by communication network 20.[000289] ML / AI platform 11 may be any ML / AI platform 11 configured to run a machine learning program and / or support a machine learning platform. Exemplary ML / AI platforms 11 include, but are not limited to, Google Tensorflow, Google Vertex Al, AWS SageMaker, and Microsoft Azure Al. In some embodiments, ML / AI platform 11 may be resident in and / or configured to run on a computer and / or cloud computing platform 13 such as Google Cloud Platform (GCP), Amazon Web Service (AWS), Rackspace, and Microsoft Azure. In some embodiments, cloud computing platform 13 and / or ML / AI platform 11 may be configured to house and / or execute one or more machine learning architectures include neural networks, artificial neural networks, Bayesian networks, and / or software or hardware that utilizes artificial intelligence.[000290] Computer 31 may be configured to act as a communication terminal to ML / AI platform 11 via, for example, communication network 20 and may facilitate provision of the results machine learning calculations (e.g., training and / or testing of a fetal health model, tuning of a fetal health model and / or use of a fetal health model) performed on ML / AI platform 11 to output device 33. Exemplary computers 31 include desktop and laptop computers, servers, tablet computers, personal electronic devices, mobile devices (e.g., smart phones), and the like. Exemplary output devices 33 are computer monitors, tablet computer devices, and outputs provided by one or more of the components of system 10. In some instances, output device 33 may be resident in computer 31. Computer 31 may be communicatively coupled to database 32, which may be configured to store information or inputs, used for machine learning and / or sets of instructions for computer 31 and / or ML / AI platform 11 as, for example, described herein. In some embodiments, computer 31 may be the same as and / or in communication with computer and / or processor 150, database 32 may be the same as and / or in communication with database 170, and / or output and / or printout device may be the same as and / or in communication with output 33.[000291] FIG. 21 A is a diagram illustrating a cross-section view of an abdomen of a pregnant human woman with a fetus 280 positioned within a uterus 260, wherein an exemplary transvaginal and / or transcervical fetal oximetry probe 115D, whichmay also be referred to herein as a transvaginal / transcervical fetal oximetry probe 115D is positioned within her endocervical canal 265 and proximate to and / or touching her cervix 270 and FIG. 21 B is a close-up view of exemplary transvaginal / transcervical fetal oximetry probe 115D shown in FIG. 21 A where the maternal tissue (including, for example, the cervix, amniotic sack, and / or amniotic fluid) is represented as an abstract shape 205 and the fetus is represented as an abstract shape 280. At times, the transvaginal / transcervical fetal oximetry probe(s) discussed herein may be referred to as “transvaginal probe(s)” for the sake of brevity. Also shown in FIG. 21A is the pregnant mammal’s urethra 275, bladder 280 and bladder wall 285.[000292] In some embodiments, transvaginal / transcervical fetal oximetry probe 115D may be configured to reside within the pregnant mammal’s endocervical canal for an extended period of time (e.g., hours) during, for example, labor and delivery of the fetus. Additionally, or alternatively, transvaginal / transcervical fetal oximetry probe 115D may be configured to reside within the pregnant mammal’s vagina and / or endocervical canal on an as-needed and / or periodic (e.g., inserted into and extracted from the endocervical canal) basis over time during, for example, the labor and delivery process.[000293] Transvaginal / transcervical fetal oximetry probe 115D includes a housing 201 with a handle 220 and a body 215. Body 215 includes one light source 105 and three detectors 160G, 160H, and 1601, each of which have a different position relative to source 105 with first detector 160G being the closest to source 105 and third detector 1601 being the furthest away from source 105. In some embodiments, handle 220 may include one or more optional components such as ECG machine 175, a transceiver 240, a processor / memory combination 245, a power supply 250, and / or a port 255. Power supply 250 may be any power supply configured to provide electrical power to one or more components of transvaginal / transcervical fetal oximetry probe 115D. In some embodiments, power supply 250 may be a battery (rechargeable or otherwise). Additionally, or alternatively, power supply may be / include an AC / DC. Port 255 may be configured to, for example, provide power to and / or act as a communications interface for transvaginal / transcervical fetal oximetry probe 115D. Exemplary ports 255 include, but are not limited to USB ports, USB-C ports, ethernet ports and the like. In some instances, port 255 may include two or more ports.[000294] Processor / memory 245 may be communicatively coupled to one or more detectors 160G, 160H, and / or 1601 and may be configured to receive one or more detected electronic and / or composite signals therefrom. Processor / memory 245 may also be communicatively coupled to light source 105 and may be configured to provide instructions thereto. Exemplary instructions include, but are not limited to, turning light source 105 on / off, a duration of time to project light, light modulation instructions, and / or what type (e.g., wavelength or set of wavelengths) and / or intensity of light to emit. In some embodiments, processor / memory 245 may be configured to pre-process and / or filter detected electronic signals and / or composite signal received from one or more detectors 160G, 160H, and / or 1601. Exemplary pre-processing includes, but is not limited to, filtering (e.g., bandpass or Kalman filter) and / or noise reduction. One or more operations performed by processor / memory 245 may be executed using one or more sets of instructions stored thereon and / or received via, for example, port 255 and / or transceiver 240. At times, these instructions may be updated via communications received via, for example, port 255 and / or transceiver 240.[000295] Transceiver 240 may be communicatively coupled to processor / memory 245, power supply 250, and / or port 255 and may be configured to communicate composite signals and / or detected electronic signals to one or more communicatively connected devices such as computer 150 and / or receiver 145. Transceiver 240 may also be configured to receive instructions regarding the operation of transvaginal / transcervical fetal oximetry probe 115D and provide these instructions to processor / memory 245. Transceiver 240 may be configured to operate via wired and / or wireless communications.[000296] A position of a detector 160G-160I relative to source 105 may be referred to herein as a source / detector distance. In some examples, detectors 160G-160I may be arranged linearly and may be positioned 1cm apart from one another so that first detector 160G is positioned 1cm away from source 105, second detector 160H is positioned 1cm away from first detector 160G, and third detector 1601 is positioned 1cm away from second detector 160H.[000297] Source 105 may project an optical signal 220 into the pregnant mammal’s tissue 205 and a resultant optical signal that has reflected off of the maternal tissue 205 and / or fetus 280 and may be detected by one or more of detector(s) 160G-160I. It is expected that the detectors 160 positioned closer tosource 105 may detect a portion of the optical signal that has been incident on the pregnant mammal’s tissue 205 but not fetus 280 and, in some embodiments, first detector 160G and / or second detector 160H may be positioned via, for example, setting of a source / detector distance, so that a majority, if not all, of an optical signal 220A and 220B detected by first and second detectors 160G and 160H, respectively, has only been incident of the pregnant mammal’s tissue 205 (i.e., is not incident on the fetus). Third detector 1601 may detect portions of the optical signal 220C that are incident on the pregnant mammal’s tissue 205 and fetus 280 as shown in FIG. 21 A. In some cases, third detector 1601 may be positioned 3-5cm away from the light source.[000298] FIG. 21 C is a diagram illustrating a cross-section view of a pregnant human woman with an exemplary transvaginal and / or transcervical fetal oximetry probe 115E, which may also be referred to herein as a transvaginal / transcervical fetal oximetry probe 115E, positioned within her endocervical canal 265 and proximate to her cervix 270 and FIG. 21 D is a close-up view of exemplary transvaginal / transcervical fetal oximetry probe 115E shown in FIG. 21 C where the maternal tissue (including, for example, the cervix, amniotic sack, and / or amniotic fluid) is represented as abstract shape 205 and the fetus is represented as abstract shape 280.[000299] Transvaginal / transcervical fetal oximetry probe 115E is similar to transvaginal / transcervical fetal oximetry probe 115D but has a different form factor in that transceiver 240, processor / memory combination 245, power supply 250, and / or port 255 are positioned in body 215 instead of in handle 220 and body 215 is attached to a cord 230. Cord 230 may include one or more wires to convey electricity and / or communications to and / or from body 215 and / or components thereof. In embodiments, cord 230 may be configured to enable the mechanical extraction of transvaginal / transcervical fetal oximetry probe 115E from the pregnant mammal’s endocervical canal.[000300] Transvaginal / transcervical fetal oximetry probe 115E may be configured with a small form factor so that it is easily inserted into and extracted from the pregnant mammal’s endocervical canal. In some embodiments, transvaginal / transcervical fetal oximetry probe 115E may be configured to reside within the pregnant mammal’s endocervical canal for an extended period of time (e.g., hours) during, for example, labor and delivery of the fetus. Additionally, oralternatively, transvaginal / transcervical fetal oximetry probe 115E may be configured to reside within the pregnant mammal’s endocervical canal on an as-needed and / or periodic basis (e.g., inserted into and extracted from the endocervical canal) over time during, for example, the labor and delivery process.[000301] FIG. 22 provides a flowchart showing an exemplary method 2200 for training, developing, and / or generating a transcervical fetal oximetry model configured to, for example, accurately calculate oximetry values for a target tissue within a body, such as a fetus in-utero using optical transcervical fetal oximetry measurements. Method 2200 may be executed by, for example, any of the system(s) and / or system components disclosed herein.[000302] Initially, in step 2205, a set (e.g., 10-10,000,000) of transcervical fetal oximetry measurements and a corresponding set (e.g., 10-10,000,000) of direct fetal oximetry measurements may be received. The transcervical fetal oximetry measurements and set of direct fetal oximetry measurements may be received from, for example, one or more of the transcervical fetal oximetry sensor (e.g., transcervical fetal oximetry sensor 115D and / or 115E) and direct-measurement-fetal-oximetry sensor (e.g., direct-measurement-fetal-oximetry sensor 115B, 200, 201, 202, 204, and / or or 400), respectively, as, for example, disclosed herein. The sets of transcervical fetal oximetry measurements and direct fetal oximetry measurements may correspond with regard to the same pregnant mammal and / or fetus and in time. To facilitate time-domain correspondence, the sets of transcervical fetal oximetry measurements and direct fetal oximetry measurements may be timestamped, or otherwise include metadata, that may be used to synchronize them in time for execution of method 2200.[000303] In step 2210, the sets of transcervical fetal oximetry measurements and direct fetal oximetry measurements may be divided into a training set (e.g., 60%, 70%, or 80% of the data sets) and a testing set (e.g., 40%, 30%, or 20% of the data sets).[000304] In step 2215, inputs to the machine learning architecture and / or software program for determining fetal oximetry values may be selected. Exemplary inputs include, but are not limited to, fetal depth, fetal heart rate, maternal heart rate, equipment characteristics, background noise characteristics, maternal geometrical characteristics, maternal physiological characteristics, fetal geometrical characteristics, fetal physiological characteristics and / or maternal oximetry values(e.g., SpO2). In some embodiments, one or more inputs may be received from a component of system 100 such as ECG 175, Doppler / ultrasound probe 135, pulse oximetry probe 130, NIRS adult hemoglobin probe 125, and / or ventilator / ventilatory signal device. Input features may be normalized to standard mean and / or variance values, such as zero mean and unit variance, and, in some instances, may be combined into composite features that are then input into the machine learning architecture. In some cases, the machine learning architecture disclosed herein may be a deep learning network architecture that may include convolutional nets and engineered feature layers. Additionally, or alternatively, the machine learning architecture may be a neural network, an artificial neural network, a Bayesian network, and / or software or hardware that utilizes artificial intelligence. In some embodiments, execution of step 2215 may include downsampling and / or activating one or convolutional layers of the machine learning architecture and / or a model generated by the machine learning architecture. In some cases, execution of step 2215 may also include adding one or more engineered features, bias, and / or classifier layers to the machine learning architecture and / or a model generated by the machine learning architecture. Additionally, or alternatively, models generated by method 2200 may include tree-based models or ensembles of layered and / or treebased models. Additionally, or alternatively, models generated by method 2200 may incorporate K-fold cross-validation to, for example, generate the expected error, receiver operating characteristic (ROC), and / or area under the curve (AUC) values for the model.[000305] In some embodiments, execution of step 2215 may include selection of one or more types of outputs that may be incorporated into the machine learning architecture. Exemplary outputs include predicted fetal oximetry (e.g., SpO2 and / or fetal tissue oxygen saturation) values and a binary fetal hypoxia, fetal hypoxemia, fetal non-hypoxia, and / or fetal non-hypoxemia (e.g., fetal SpO2 above / below 30%) indication.[000306] In step 2220, the training data set may be input into the machine learning architecture to generate and / or train a first version of a transcervical fetal oximetry model that may be configured to, for example, to determine and / or predict a first set of outputs (e.g., fetal SpO2 values, fetal tissue oxygen saturation, and / or fetal hypoxemia or non-hypoxemia determinations) using transcervical fetal oximetry measurements and corresponding direct fetal oximetry measurements as, forexample, a ground truth. The first version of the transcervical fetal oximetry model may include a plurality of layers and / or functions and, in some cases, may include one or more small layered network(s), sub-networks, and / or a Support Vector Machine. In some embodiments, execution of step 2220 may include communication of the machine learning inputs and / or machine learning architecture to, for example, a machine learning computer platform and / or neural network such as a machine learning platform like ML / AI platform 11. In step 2225, the first version of the transcervical fetal oximetry model may be stored in a database such as database 15 and / or 170.[000307] In step 2230, the first version of the transcervical fetal oximetry model and / or first set of outputs may be tested using, for example, the testing data set from step 2210. The results of the testing may then be evaluated (step 2235) and used to modify the first version of the transcervical fetal oximetry model thereby generating a second version of the transcervical fetal oximetry model (step 2240) via, for example, training and / or tuning the first version of the transcervical fetal oximetry model using the machine learning architecture. In some embodiments, the second version of the transcervical fetal oximetry model may be similar, or identical to, the first version of the fetal oximetry model.[000308] FIG. 23 is a flowchart illustrating an exemplary method 2300 for the determination of a fetal oximetry value for a fetus using a transcervical oximetry model that may be generated via, for example, execution of method 2200. Method 2300 may be performed by, for example, any of the systems or system components disclosed herein.[000309] Initially, in step 2305, light transmission data for a pregnant mammal’s cervical tissue and fetus may be received from, for example, a photodetector like detector 160 and / or a probe like fetal hemoglobin probe 115 of a transcervical fetal oximetry sensor. The light may be transmitted from a light source, through the pregnant mammal’s cervical tissue (as well as other tissue or layers like an amniotic sac and amniotic fluid), be incident upon the fetus, and be reflected and / or backscattered therefrom and detected by the photodetector. The light transmission data received in step 2305 may then be put into and / or processed by the transcervical fetal oximetry model (e.g., the transcervical fetal oximetry model of step 2240) in step 2310. In some embodiments, the light transmission data received in step 2305 may be pre-processed prior to execution of step 2310. The pre-processingmay include, for example, filtering with, for example, a Kalman or bandpass filter, application of a noise reduction model, removal of a portion of the light transmission data that is incident only the pregnant mammal (i.e., not incident on the fetus), and / or isolation of a portion of the light incident on the fetus from the received light transmission data. On some occasions, removal of a portion of the light transmission data that is incident only the pregnant mammal (i.e., not incident on the fetus), and / or isolation of a portion of the light incident on the fetus from the received light transmission data may be accomplished by, for example, receiving a maternal heartrate signal, using the maternal heart rate signal to identify the portion of the light transmission data contributed by the pregnant mammal and then subtracting the portion of the light transmission data contributed by the pregnant mammal from the light transmission data. Additionally, or alternatively, isolation of the fetal portion of the light transmission data may be accomplished by, for example, receiving a fetal heartrate signal, using the fetal heart rate signal to identify the portion of the light transmission data contributed by the fetus and then subtracting the remainder of light transmission data and / or amplifying the portion of the light transmission data contributed by the fetus. Additionally, or alternatively, isolation of the fetal portion of the light transmission data may include determining a fetal position and / or fetal depth and then[000310] In step 2315, an oximetry value for the fetus within the pregnant mammal’s abdomen may be determined and / or output by the transcervical fetal oximetry model. The oximetry value may be, for example, a fetal hemoglobin oxygen saturation level, a fetal tissue oxygen saturation level, an indication of fetal hypoxia, an indication of fetal hypoxemia, and / or an alert condition indicating that a fetal oximetry value indicates the fetus may be in distress. The oximetry value may then be communicated to a display device like display device 14 and / or 155 for display to a user such as a clinician and / or the pregnant mammal (step 2320).[000311] FIG. 24 is a flowchart illustrating an exemplary method 2400 for validating fetal oximetry information using a comparison of fetal heart rate information derived from multiple sources and / or using fetal heartrate information to determine whether directly-measured fetal optical signals, transcervically-measured fetal optical signals, and / or transabdominally-measured fetal optical signals are valid enough to use for fetal oximetry calculations and / or determinations. Method 2400may be performed by, for example, any of the system(s) and / or system components disclosed herein.[000312] In step 2405, a directly-measured fetal optical signal, a transcervically-measured fetal optical signal, and / or a transabdominally-measured fetal optical signal may be received from, for example, a direct-measurement-fetal-oximetry sensor, a transcervical fetal oximetry sensor, and / or a transabdominal fetal oximetry sensor like the fetal oximetry sensors disclosed herein (e.g., direct-measurement-fetal-oximetry sensor 115B, 200, 201, 202, 204, and / or 400, transcervical fetal oximetry sensor 115D and / or 115E, and / or transabdominal-fetal-oximetry sensor 115A).[000313] In step 2410, an optically-derived fetal heart rate may be determined using the directly-measured fetal optical signal, the transcervically-measured fetal optical signal, and / or the transabdominally-measured fetal optical signal received in step 2405. The optically-derived fetal heart rate may be determined using, for example, a plethysmograph signal derived from the received fetal optical signal(s).[000314] Optionally, in step 2415, fetal ECG information may be received from, for example, a fetal ECG measurement device like the fetal ECG measurement devices disclosed herein (e.g., fetal ECG measurement device 175A, 175B, 175C, 175D, or 175E) and / or a combined fetal ECG and direct-measurement-fetal-oximetry sensor like combined fetal ECG and direct-measurement-fetal-oximetry sensor 400. Then, in step 2420, an ECG-derived fetal heart rate may be determined using the fetal ECG information received in step 2415. The ECG-derived fetal heart rate may be determined via any acceptable method including, but not limited to, performing R-wave detection and calculating an R-wave interval measurement, determining a number of R waves / minute, and / or determining a number of QRS complexes / minute present in the fetal ECG information.[000315] Additionally, or alternatively, in step 2425, fetal heart rate information may be received from an external device such as, for example, a Doppler ultrasound device like Doppler ultrasound sensor 135.[000316] In step 2430, the optically-derived fetal heart rate determined in step 2410 may be compared with the ECG-derived fetal heart rate determined in step 2420 and / or the fetal heart rate information received from the external device in step 2425 to, for example, determine differences therebetween and / or a degree of alignment thereof.[000317] In step 2435, it may be determined whether a result of the comparison of step 2430 is within a specified range of values. The specified range of values may be, for example, a threshold difference (e.g., ±5 beats per minute (bpm), ±10 bpm, and / or ±3%, ±5%, ±8% or ±10%) between the compared fetal heart rate values.[000318] When the result of the comparison is not within the specified range of values (step 2435), an error message may be sent to an output device and / or process 2400 may end (step 2440). The error message may indicate, for example, that the fetal oximetry sensor and / or fetal ECG sensor may not be properly positioned on the fetus and / or that the fetal oximetry information may not be reliable.[000319] When the result of the comparison is within the specified range of values (step 2435), fetal-oximetry information may be determined using the directly-measured fetal optical signal, the transcervically-measured fetal optical signal, and / or the transabdominally-measured fetal optical signal (step 2445). The fetal-oximetry information may include, for example, fetal hemoglobin oxygen concentration, pulse oximetry information, and / or tissue oxygen saturation levels. Additionally, or alternatively, the fetal-oximetry information may include, for example, an indication of fetal health or wellness and / or an indication of a trend for fetal health, wellness, and / or oximetry information over time.[000320] Hence, systems, devices, and methods for determining fetal-oximetry information have been herein disclosed. In some embodiments, use of the systems, devices, and methods described herein may be particularly useful during the labor and delivery of the fetus (e.g., during the first and / or second stage of labor) because it is difficult to assess fetal wellness and / or oxygenation status during the labor and delivery process.

Claims

CLAIMSWe claim:

1. A computer-implemented method comprising:receiving fetal oximetry information and fetal electrocardiogram (ECG) information for a fetus;inputting the fetal oximetry information and fetal ECG information into a fetal health model;receiving an output from the fetal health model, the output including an indication of fetal health that is responsive to the fetal oximetry information and fetal ECG information; andproviding the indication to an output device.

2. The computer-implemented method of claim 1 , further comprising:synchronizing the fetal oximetry information and fetal ECG information prior to the inputting.

3. The computer-implemented method of claim 1 or 2, wherein the fetal health model is trained using at least one of fetal health information, neonatal health information, correlations between fetal health information and neonatal health information, correlations between fetal health information and fetal oximetry and / or fetal ECG information, and correlations between neonatal health information and fetal oximetry and / or fetal ECG information.

4. The computer-implemented method of claim 3, wherein the neonatal health information includes at least one of a result of a neurological test, an Apgar score, respiratory information, pulse oximetry information, pulse, heartrate, skin color, a blood test result, and an umbilical cord blood test result, and a degree of responsiveness to stimulation.

5. The computer-implemented method of claim 3 or 4, wherein the fetal health information includes at least one of fetal oximetry information, fetal ECG information, a result of an analysis of variations of the fetal oximetry and / or fetal ECG information over time, and a result of a fetal ECG ST analysis.

6. The computer-implemented method of any of the above claims, wherein the fetal oximetry information is received from at least one of a transabdominal fetal oximetry sensor, a transcervical fetal oximetry sensor positioned proximate to the fetus, and a direct fetal oximetry sensor in contact with skin of the fetus.

7. The computer-implemented method of any of the above claims, wherein the fetal oximetry information and the fetal ECG information are received from a combined fetal oximetry and fetal ECG sensor in contact with skin of the fetus.

8. The computer-implemented method of any of the above claims, wherein the fetal ECG information is received from a fetal ECG sensor in contact with skin of the fetus.

9. The computer-implemented method of any of the above claims, further comprising:verifying a sensor providing the fetal oximetry information and / or fetal ECG information is properly positioned on the fetus using the fetal ECG information.

10. The computer-implemented method of claim 9, further comprising:determining fetal heartrate information using the fetal ECG information; and receiving a fetal heartrate signal, wherein the verification comprises:comparing the fetal heartrate information determined using the fetal ECG information and the received fetal heartrate signal; anddetermining that the sensor is properly positioned on the fetus responsively to a result of the comparison.

11. The computer-implemented method of claim 9, further comprising:determining fetal heartrate information using the fetal ECG information; and receiving maternal heartrate information, wherein the verification comprises:comparing the fetal heartrate information determined using the fetal ECG information and the received maternal heartrate information; and determining that the sensor is properly positioned on the fetus responsively to a result of the comparison.

12. The computer-implemented method of any of claims 9-11, wherein the verifying is performed prior to inputting the fetal oximetry information and fetal ECG information into the fetal health model and, when proper positioning of the sensor on the fetus cannot be verified, an error message is provided to the output device instead of inputting the fetal oximetry information and fetal ECG information into the fetal health model.

13. The computer-implemented method of any of claims 9-12, further comprising: receiving an impedance measurement from a source of the fetal ECG information, wherein the verification is responsive to the impedance measurement.

14. A computer-implemented method comprising:receiving transcervical fetal oximetry information for a fetus;inputting the transcervical fetal oximetry information into a transcervical fetal oximetry model;receiving an output from the transcervical fetal oximetry model; determining an oximetry value for the fetus; andproviding the oximetry value to a display device.

15. The computer-implemented method of claim 14, wherein the transcervical fetal oximetry model is trained using at least one of fetal health information, neonatal health information, correlations between fetal health information and neonatal health information, correlations between fetal health information and transcervical fetal oximetry information, and correlations between neonatal health information transcervical fetal oximetry information.

16. The computer-implemented method of claim 15, wherein the neonatal health information includes at least one of a result of a neurological test, an Apgar score, respiratory information, pulse oximetry information, pulse, heartrate, skin color, a blood test result, and an umbilical cord blood test result, and a degree of responsiveness to stimulation.

17. The computer-implemented method of claim 15 or 16, wherein the fetal health information includes at least one of fetal oximetry information, fetal ECG information, a result of an analysis of variations of the fetal oximetry and / or fetal ECG information over time, and a result of a fetal ECG ST analysis.

18. A device comprising:an ECG lead configured to be in electrical communication with skin of a fetus in utero and provide fetal ECG measurements to a communication interface;a direct-measurement-fetal-oximetry sensor comprising at least one light source configured to emit light of at least two different wavelengths into the fetus and a photodetector configured to detect light reflected from the fetus and provide a signal corresponding to the detected light to the communication interface;a housing for housing the ECG lead and direct-measurement-fetal-oximetry sensor;the communication interface in communication with the ECG lead and direct-measurement-fetal-oximetry sensor and configured to communicate data received from the ECG lead and direct-measurement-fetal-oximetry sensor to an external device; anda positioning extension configured to enable positioning the housing on fetal skin so that the ECG lead and the direct-measurement-fetal-oximetry sensor are in contact with the fetal skin.

19. The device of claim 18, wherein the communication interface is at least one of a wireless transceiver and a wire.

20. The device of claim 18 or 19, further comprising:a reference electrode positioned and configured to contact and / or electrically couple to maternal tissue.21.The device of any of claims 18-20, wherein the housing comprises a first side in which the ECG lead and the direct-measurement-fetal-oximetry sensor are positioned and a second side, the second side opposing the first side and including a stabilization device configured to face an internal uterine wall when in situ.

22. The device of claim 21 , wherein a size and / or volume of the stabilization device is adjustable.

23. The device of claim 22, wherein the stabilization device is inflatable and further comprises:an inflation line resident in the positioning extension, the inflation line being in communication with the stabilization device and configured to communicate fluid to and / or from the stabilization device, thereby adjusting a size and / or volume of the stabilization device.

24. The device of claim 23, wherein a degree of inflation of the stabilization device is responsive to back pressure exerted on the inflation line.

25. The device of claim 23 or 24, wherein a degree of inflation of the stabilization device is responsive to ECG data and / or data from the direct-measurement-fetal-oximetry sensor.

26. The device of any of claims 21-25, wherein the stabilization device comprises a material that expands when exposed to amniotic fluid.

27. The device of any of claims 21-26, wherein the stabilization device comprises a material that expands into space between the fetus and internal uterine wall.

28. The device of any of claims 21-27, wherein the stabilization device is configured to occupy space between the fetus and internal uterine wall and assist with maintaining contact between the fetal skin and the ECG lead.

29. The device of any of claims 18-28, wherein a portion of an exterior surface of the device is coated in a lubricious coating.

30. The device of any of claims 18-29, wherein a portion of an exterior surface of the device comprises a material with a low coefficient of friction.

31. The device of any of claims 18-30, further comprising an optically-isolating feature configured to minimize optical shunting and / or optically isolate the photodetector from the light source.

32. The device of any of claims 18-31, further comprising a temperature sensor.

33. The device of any of claims 18-32, wherein the photodetector is a first photodetector positioned at a first distance from the light source, the device further comprising a second photodetector positioned at a second distance from the light source.

34. A method of using the device of any of claims 18-33 to obtain fetal ECG measurement data and fetal oximetry data.

35. A computer-implemented method comprising:receiving a directly measured fetal optical signal from a direct-measurement-fetal-oximetry sensor;determining an optically-derived fetal heart rate using the directly measured fetal optical signal;receiving fetal ECG information from a fetal ECG measurement device; determining an ECG-derived fetal heart rate using the fetal ECG information;comparing the optically-derived fetal heart rate with the ECG-derived fetal heart rate; anddetermining direct-measurement-fetal-oximetry information using the directly measured fetal optical signal responsively to a result of the comparison.

36. The computer-implemented method of claim 35, wherein the optically-derived fetal heart rate is determined using a plethysmograph signal derived from the directly measured fetal optical signal.

37. The computer-implemented method of claim 35 or 36, wherein the ECG-derived fetal heart rate is determined by at least one of performing R-wave detection and calculating an R-wave interval measurement, determining a number of R waves per minute, and determining a number of QRS complexes per minute.

38. The computer-implemented method of any claims 35-37, further comprising: receiving fetal heart rate information from an external device; andcomparing the optically-derived fetal heart rate with the fetal heart rate information received from the external device.

39. The computer-implemented method of claim 38, wherein the external device comprises a Doppler ultrasound device.

40. The computer-implemented method of any of claims 35-39, wherein the direct-measurement-fetal-oximetry information includes at least one of fetal hemoglobin oxygen concentration, pulse oximetry information, and tissue oxygen saturation levels.41.The computer-implemented method of any of claims 35-40, wherein the fetal ECG information is received from a combined fetal ECG and direct-measurement-fetal-oximetry sensor.

42. The computer-implemented method of any of claims 35-41 , further comprising:providing the direct-measurement-fetal-oximetry information to an output device.

43. The computer-implemented method of any of claims 35-42, further comprising:determining whether a result of the comparison is within a specified range of values, wherein the determining of the direct-measurement-fetal-oximetry information is performed when the result of the comparison is within the specified range of values.

44. The computer-implemented method of claim 43, wherein the specified range of values comprises a threshold difference between the optically-derived fetal heart rate and the ECG-derived fetal heart rate.

45. The computer-implemented method of claim 44, wherein the threshold difference is at least one of ±5 bpm, ±10 bpm, and ±10%.

46. The computer-implemented method of any of the above claims, further comprising:when the result of the comparison is not within the specified range of values, sending an error message to an output device.

47. The computer-implemented method of claim 46, wherein the error message indicates at least one of that the direct-measurement-fetal-oximetry sensor may not be properly positioned on the fetus, that the fetal ECG measurement device may not be properly positioned on the fetus, and that the fetal oximetry information may not be reliable.

48. A computer-implemented method comprising:receiving at least one of a directly-measured fetal optical signal, a transcervically-measured fetal optical signal, and a transabdominally-measured fetal optical signal;determining an optically-derived fetal heart rate using the at least one of the directly-measured fetal optical signal, the transcervically-measured fetal optical signal, and the transabdominally-measured fetal optical signal;receiving fetal heart rate information from at least one of a fetal ECG measurement device and an external device;comparing the optically-derived fetal heart rate with the received fetal heart rate information;determining whether a result of the comparison is within a specified range of values; andwhen the result of the comparison is within the specified range of values, determining fetal-oximetry information using the at least one of the directly-measured fetal optical signal, the transcervically-measured fetal optical signal, and the transabdominally-measured fetal optical signal.

49. The computer-implemented method of claim 48, wherein the optically-derived fetal heart rate is determined using a plethysmograph signal derived from the at least one of the directly-measured fetal optical signal, the transcervically-measured fetal optical signal, and the transabdominally-measured fetal optical signal.

50. The computer-implemented method of claim 48 or 49, wherein the directly-measured fetal optical signal is received from a direct-measurement-fetal-oximetry sensor, the transcervically-measured fetal optical signal is received from a transcervical fetal oximetry sensor, and the transabdominally-measured fetal optical signal is received from a transabdominal fetal oximetry sensor.51.The computer-implemented method of any of claims 48-50, wherein the fetal heart rate information is received from the fetal ECG measurement device, and the method further comprises:determining an ECG-derived fetal heart rate using fetal ECG information received from the fetal ECG measurement device.

52. The computer-implemented method of claim 51, wherein the ECG-derived fetal heart rate is determined by at least one of performing R-wave detection and calculating an R-wave interval measurement, determining a number of R waves per minute, and determining a number of QRS complexes per minute.

53. The computer-implemented method of any of claims 48-52, wherein the external device comprises a Doppler ultrasound device.

54. The computer-implemented method of any of claims 48-53, wherein the specified range of values comprises a threshold difference between the optically-derived fetal heart rate and the received fetal heart rate information.

55. The computer-implemented method of claim 54, wherein the threshold difference is at least one of ±5 bpm, ±10 bpm, and ±10%.

56. The computer-implemented method of any of claims 48-55, further comprising:when the result of the comparison is not within the specified range of values, sending an error message to an output device.

57. The computer-implemented method of claim 56, wherein the error message indicates at least one of that a fetal oximetry sensor may not be properly positioned on the fetus, that the fetal ECG measurement device may not be properly positioned on the fetus, and that the fetal oximetry information may not be reliable.

58. The computer-implemented method of any of claims 48-57, wherein the fetal-oximetry information includes at least one of fetal hemoglobin oxygen concentration, pulse oximetry information, and tissue oxygen saturation levels.

59. The computer-implemented method of any of claims 48-58, wherein the fetal heart rate information is received from a combined fetal ECG and direct-measurement-fetal-oximetry sensor.

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