Patent Publication Number: US-2007102501-A1

Title: Device and methods for counting, timing, recording, and charting fetal movement frequency

Description:
FIELD OF THE INVENTION  
      The present invention relates to fetal health monitoring, more particularly, to an electronic device for helping a pregnant woman count and chart fetal movements.  
     BACKGROUND OF THE INVENTION  
      Perceived fetal movement by a pregnant woman is regarded as an excellent indication of fetal well-being. Fetal movement serves as an indirect measure of the central nervous system integrity and function. Although fetal movement can be documented by ultrasound as early as 7-8 weeks of pregnancy, the first fetal movement or “flutter” is not usually felt by the mother until the 16th week (for women who have delivered a baby) to the 20th week (for women pregnant for the first time). Movements generally increase in strength and frequency through pregnancy, particularly at night, and when the woman is at rest. At the end of pregnancy (36 weeks and beyond), there is normally a slow change in movements, with fewer violent kicks and more rolling and stretching fetal movements.  
      Maternal counting and tracking of fetal movements is called kick count. It has been accepted as a cheap, simple, valuable, effective, reliable and harmless screening of fetal well-being in both low and high risk pregnancies. For example, a sudden decrease in fetal movements may indicate potential problems and may need further evaluation of fetal well-being. As shown at http://www.MOMStudy.com, the International MOMSTUDY, currently with more than 3000 participants, has found that more than half of stillbirth mothers (nearly three quarter in third trimester unexplained stillbirths) reported their first reason to believe their baby not doing well is a reduction in fetal activity. Half of the affected mothers have perceived a gradual reduction of fetal movement several days before.  
      Several formal protocols for kick count have been developed over the years. However, there is no single accepted protocol. For example, Pearson and Weaver&#39;s study (“British Medical Journal,” Vol.  1 , pp. 1305-1307, May 29, 1976) suggested counting 10 fetal movements daily and reporting if there are less than 10 movements in 12 hours. Sadovsky et al. (“Obstetrics and Gynecology,” Vol. 50, No. 1, pp. 49-55, July 1977) suggested counting fetal movements for 30 minutes to one hour, three times a day, and if there are less than 3 movements in one hour, the count is continued for 6-12 hours and reporting if there are less than 10 movements in 12 hours, while Neldam&#39;s study (“The Lancet,” pp. 1222-1224, Jun. 7, 1980,) suggested counting fetal movement for 2 hours after a meal, 3 times a week and reporting if there are less than 3 movements per hour. In Moore and Piacquadio&#39;s study (“American Journal of Obstetrics and Gynecology,” Vol. 160, pp. 1075-1080, May 1989), the fetal mortality rate significantly fell from 8.7 to 2.1 per 1,000 deliveries by counting fetal movements and taking prompt actions for further evaluation of fetal well-being when the pregnant women did not perceive 10 movements within a two hour time frame. The mean interval time for 10 perceived fetal movements was 20.9+/−18.1 minutes (mean +/−standard deviation). The number of antepartum testing (nonstress test, contraction stress test, biophysical profile) prompted by fetal movement count increased by 13%. Regardless of the counting methods used, this and other existing studies suggested an improvement in perinatal outcomes with early identification of decreased fetal activity. There are other on-going research activities to optimize the benefit of kick count, the information of which are readily available to those of ordinary skill and not discussed here for simplicity.  
      In general, the observation may be done at approximately the same time each day, preferably when the baby is usually very active or after mother has had a meal or snack. The mother may note the starting time and begin counting fetal movements (rolls, kicks, punches, turns), excluding hiccups, and continue counting until a certain number of movements are noted. Following the Moore and Piacquadio&#39;s study, perception of 10 distinct movements in a period of up to 2 hours may be considered reassuring. Once 10 movements have been perceived, the count may be discontinued.  
      Regardless of the type of protocol selected for a kick count, the efficacy of the kick count is affected by the accuracy in recording fetal movements during the kick count. Thus, there is a need for a device that records the time taken for a predetermined number of fetal movements, and also provides a bonding experience for the mother and her partner with the fetus during the pregnancy period. Traditionally, kick count chart was used where the information about the kick count session is recorded manually and, as a consequence, noncompliance has been a significant issue. Thus, there is also a need for a simple, user friendly device for registering and charting fetal movements, where the user may operate the device in one of the multi language settings. A pregnant woman may report the stored kick times to the prenatal care clinic or obstetrical care provider.  
     OBJECTIVES OF THE INVENTION  
      It is an object of this invention to provide methods of kick count, in particular counting, timing and recording a predetermined number of fetal movements using the count-to-ten protocol, e.g., 10 fetal movements over 2 hours, as a means for fetal well-being monitoring.  
      It is another object of this invention to provide a simple method of fetal movement counting and charting that can be used at any time of the day, at any stage of pregnancy to enhance the compliance with the kick count protocol.  
      It is yet another object of this invention to incorporate voice and audio technology to simplify fetal movement counting.  
      It is a further object of this invention to provide incentive for a pregnant woman to perform fetal movement counting by incorporating automatic audio playback of the fetal heart sounds at the end of each counting session. The invention also incorporates days counter for the user to enter the pregnancy progress and update it at any time.  
     SUMMARY OF THE INVENTION  
      The present invention provides methods and a device for charting fetal movements. The user of the device records each movement (or kick) by pressing a button on the device. The device records the time interval between the first kick and the tenth kick in each kick count session, where the elapsed time interval is referred to as “KickTime” hereinafter. The device stores ten KickTimes so that the user can review the frequency of the kicks from one sequence to the next. In addition, the device has a sound recording and playback function that allows the user to record the fetal heartbeat sound for playback. The device includes audible instructions to inform the user how to operate the device in each mode. The device also stores and updates the weeks and days of the woman&#39;s pregnancy progress.  
      In one aspect of the present invention, a device for charting fetal movements includes: an input member actuatable by a user to input fetal movement information into the device, the information corresponding to one or more perceived fetal movements; a kick counter for recording the fetal movement information during a kick count session, the kick count session being a period for recording a preset number of fetal movements; and a display screen for displaying icons during the kick count session, wherein each icon corresponds to one of the perceived fetal movements. The user of the device can count the perceived fetal movements recorded during the kick count session by counting the icons displayed during the kick count session.  
      In another aspect of the present invention, a method for charting fetal movements using a device that has a display screen includes steps of: causing the device to receive fetal movement information from the user thereof, the information corresponding to one or more perceived fetal movements; causing the device to record the fetal movement information during a kick count session, the kick count session being a period for recording a preset number of fetal movements; and causing the device to display icons on the display screen during the kick count session, wherein each icon corresponds to one of the perceived fetal movements. The user of the device can count the perceived fetal movements recorded during the kick count session by counting the icons displayed during the kick count session.  
      These and other features, aspects and advantages of the present invention will become better understood with reference to the following drawings, description and claims. 
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS:  
       FIGS. 1A-1C  are a front, a side and a back elevation of a kick-count device, respectively, in accordance with the present invention.  
       FIG. 2A  is an exemplary display on the device of  FIG. 1A  in a “kick” mode for recording the times of fetal movements.  
       FIG. 2B  is an exemplary display on the device of  FIG. 1A  in a “play animation” mode for playing an animation upon completion of the kick mode.  
       FIG. 2C  is an exemplary display on the device of  FIG. 1A  in a “kick memory” mode for reviewing KickTimes recorded in the kick mode.  
       FIG. 2D  is an exemplary display on the device of  FIG. 1A  in a “play” mode for playing a fetal heartbeat sound recorded therein.  
       FIG. 2E  is an exemplary display on the device of  FIG. 1A  in a “record” mode for recording a fetal heartbeat sound to be played in the play mode.  
       FIG. 2F  is an exemplary display on the device of  FIG. 1A  in a “setup” mode for inputting information of the current stage of pregnancy, selecting a language and updating a “Days To Go” countdown.  
       FIG. 3  is a functional block diagram of the device depicted in  FIG. 1A .  
       FIGS. 4A-4B  show a flow chart illustrating an operational sequence of the modes depicted in connection with  FIGS. 2A-2F .  
       FIGS. 5A-5C  show a system flowchart of the device depicted in  FIG. 1A .  
       FIG. 6  shows a flow chart illustrating the steps that may be carried out to count kicks using the device depicted in  FIG. 1A  according to the present invention. 
    
    
     DETAILED DESCRIPTION OF THE INVENTION  
      The following detailed description is of the best currently contemplated modes of carrying out the invention. The description is not to be taken in a limiting sense, but is made merely for the purpose of illustrating the general principles of the invention, since the scope of the invention is best defined by the appended claims.  
      Broadly, the present invention provides a device that is intended to help a pregnant woman chart fetal movements. The device may help the pregnant woman record and evaluate the elapsed time for ten perceived fetal movements to occur in a kick count session. The user of the device may record each movement (or kick) by pressing a button on the device and measure the KickTime of the kick count session. The device may store data of ten KickTimes so that the user can review the frequency of the kicks from one sequence to the next. In addition, the device may have a sound recording and playback function that enables the user to record and play a fetal heartbeat sound. The device may also store and update the weeks and days of the woman&#39;s pregnancy progress.  
       FIG. 1A  is a front elevation of a kick-count device  10  in accordance with the present invention. As illustrated, the device  10  may include: an input member including an EVENT button  12  for recording events and a MODE button  14  for switching between modes; a mode window  16  for indicating the active mode; a kick count window  18  that includes a time display  24 , a memory number display  26 , and a 10-footprint display  28 ; a pregnancy progress window  20  that includes a week-and-day counter  30  and a day counter  32 . (Hereinafter, the terms footprints and feet are used interchangeably.) The week-and-day counter  30  may indicate a count forward of the pregnancy in weeks and days from the inception of pregnancy, while the day counter  32  may indicate a countdown of ‘days-to-go’ during the last 99 days of the pregnancy. As will be explained later, the words “DAYS TO GO” of the day counter  32  may also be used to select the language by the user of the device  10 . The device  10  may have one LCD screen that is masked by a front enclosure  13  to be perceived as three separate windows  16 ,  18  and  20 . The LCD screen may be also used to display a digital image of the baby&#39;s ultrasound scan. Alternatively, a printout of the digital image may be slotted into a clear plastic pouch, where the pouch is attached to the front enclosure  13  or the back enclosure  15  ( FIG. 1B ).  
      The device  10  may also have a hole  22  through the enclosure to attach a strap for a key ring, wrist strap, necklace or the like. In an alternative embodiment, the device  10  may have a clip feature (not shown in  FIG. 1A ) so that it can be attached to a belt, clothing or a bag.  
      The website address  37  (shown in  FIG. 1C ), Voikex™ logo  35  (shown in  FIG. 1C ) and device name  33  may be located on the device  10 . These graphics may be added as a part of the molding process or printed onto the device  10 . The EVENT button  12  may be concave and level with the enclosure at the edges. The EVENT button  12  may be made of an elastomeric material, while the MODE button  14  may be made of a rigid plastic. In another alternative embodiment, the EVENT button  12  may be located at the top the device  10 .  
       FIG. 1B  is a side elevation of the kick-count device  10  depicted in  FIG. 1A . As illustrated, the device  10  may include a back enclosure  15  that may be fixed to the front enclosure  13  securely and may not snap open when subjected to predictable impacts. The back enclosures  15  may include a removable battery cover  36  and holes  34  for a speaker located therewithin. The speaker, not shown in  FIGS. 1A-1C , may be used to record a recognizable heartbeat sound from a Doppler heartbeat audio instrument and play the recorded sound. Further detail of the speaker will be given in connection with  FIG. 2E . The front and back enclosure  13 ,  15  may have a pregnancy totem shape reminiscent of pregnant abdomen with a gentle female curvature.  
       FIG. 1C  is a back elevation of the kick-count device  10  depicted in  FIG. 1A . As illustrated, the back enclosure  15  may include: holes  34  for the speaker; a removable battery cover  36 ; and a battery cover opener  38  that opens the removable battery cover  36 .  
      The device  10  may have the following (operational) modes; kick mode, play animation mode, kick memory mode, play mode, record mode and setup mode. The device may include audible instructions for each mode that will play after a predetermined time delay. These instructions may inform the user in the correct language how to operate the device in that particular mode. The user of the device  10  may press the MODE button  14  to switch from one mode to another while one of the icons in the mode window  16  may be highlighted to indicate the current mode.  FIG. 2A  is an exemplary display on the device  10  in a “kick” mode for recording the times of fetal movements. The device  10  may default to the kick mode when awaken from an idle state. As illustrated, a kick icon  50  may be highlighted in the mode window  16  to indicate that the device is currently operating in the kick mode. In this mode, the user of the device (preferably the mother) may record the times of fetal movements (or, shortly, kicks) by pressing the EVENT button  12  each time that the mother perceives a fetal movement. In the kick mode (and other modes described in  FIGS. 2B-2F ), the week-and-day counter  30  of the pregnancy progress window  20  may display a count forward from inception in weeks and days. If the current date is in the last 99 days of the pregnancy, the day counter  32  may display a count down to delivery in days.  
      In each (kick count) session, the user may record ten consecutive kicks. To indicate the number of kicks recorded in the current session, the kick count window  18  may display the images of footprint  28 . When a kick is recorded by pressing the EVENT button  12 , another image of the footprint  28  may be added to the kick count window  18 . After 10 kicks have been recorded, the time taken to count these ten kicks (or equivalently, KickTime) may be displayed on the time display  24  of the kick window  18 , as illustrated in  FIG. 2B .  FIG. 2B  is an exemplary display on the device  10  in a “play animation” mode. Upon completion of the kick mode in  FIG. 2A , the device  10  may default to the play animation mode, wherein the animated footprints  28  may walk up the kick window  18  along with a heartbeat sound for ten seconds as indicated in a text bubble  52 . The fetal heartbeat sound may be recorded in the “record” mode as explained in connection with  FIG. 2E . The play animation mode may alert the user that ten kicks have been recorded and one session is over.  
      As mentioned above, the user may record ten kicks in each session. The number “ten” has been selected to utilize the protocol recommended by American College of Obstetricians and Gynecologists (ACOG): 10 fetal movements (kicks) in 2 hours. However, it should be apparent to those of ordinary skill that the device  10  may be designed to record other suitable number of fetal movements in each session depending upon the kick count protocol.  
      As mentioned, upon completion of the kick mode ( FIG. 2A ), the device  10  may enter into the play animation mode ( FIG. 2B ) automatically. Likewise, once the animation is complete, the device  10  may default to a “kick memory” mode.  FIG. 2C  is an exemplary display on the device  10  in the kick memory mode for reviewing the KickTimes recorded in the kick mode in  FIG. 2A . As illustrated in  FIG. 2C , a memory icon  54  may be highlighted in the mode window  16  to indicate that the device is currently operating in the kick memory mode. In this mode, the device  10  may display ten KickTime records one at a time. The EVENT button  12  may be used to scroll through the ten KickTime records. For each KickTime record displayed, the corresponding memory number (or equivalently, a stack number of the displayed KickTime record in the ten KickTime memory) may be displayed on the memory number display  26 . To help the user trace the memory number, a footprint  28  may be highlighted on the kick count window  18 . The user may press the MODE button  14  to exit the kick memory mode and switch to a “play” mode.  
       FIG.2D  is an exemplary display on the device  10  in a play mode for playing a heartbeat sound recorded in the device  10 . In this mode, the user may be able to play the fetal heartbeat sound, which is preferably a fetal heartbeat sound recorded from a Doppler instrument, by pressing down the EVENT button  12  for more than 0.15 seconds. As depicted in  FIG. 2D , a play icon  56  may be used to indicate the device is currently operating in the play mode. The play icon  56  may flash during the playback of the sound recording or stay being highlighted if the device  10  does not have any recorded sound. The speaker volume may be controlled by pressing down the EVENT button  12  for more than 2 seconds during which the volume may toggle between 25% and 100% of the maximum level. Then, the user may set the volume to a desired level by releasing the EVENT button  12 .  
      The user may press the MODE button  14  to exit the play mode and switch to a “record” mode.  FIG. 2E  shows an exemplary display on the device  10  in the record mode for recording the heartbeat sound to be played in the play mode. As illustrated, a record icon  58  may be displayed on the mode window  16  to indicate that the device  10  is currently operating in the record mode. The user may bring the device  10  to an obstetrical provider and record the fetal heartbeat sound from a Doppler instrument by pressing and holding the EVENT button  12 . Initially, the device  10  may be programmed with a pre-recorded heartbeat sound. This may be erased when the user makes her first recording. Also, a new recording may automatically overwrite the previous one. The device  10  may record the heartbeat sound for 10 seconds. The record icon  58  may flash for 10 seconds from the start of recording and subsequently stay highlighted to indicate that the recording has completed. It should be apparent to those of skill in the art that the device  10  may be easily programmed to record more or less than 10 seconds.  
      The user may press the MODE button  14  to exit the record mode and switch to a “setup” mode.  FIGS. 2F  shows an exemplary display on the device  10  in the setup mode for inputting information of the current stage of pregnancy into the device  10 . The setup mode has three submodes: “SetWeeks”, “SetDates” and “SetLanguage” submodes. When the device  10  enters into the SetWeeks submode, the number representing the “Weeks Pregnant” in the week-and-day counter  30  may flash indicating that the device  10  is operating in the SetWeeks submode. The user may press the EVENT button  12  to set the weeks, where the weeks may loop from 0 to 42 and back to 0. There may be a time delay before the device  10  switches from the SetWeeks submode to the SetDays submode. In the SetDays submode, the number representing the “Days Pregnant” (in addition to the weeks pregnant) in the week-and-day counter  30  may flash and the user may press the EVENT button  12  to set the days, wherein the days may loop from 0 to 6.  
      The device  10  maybe set to count forward from the inception of pregnancy as well as to count down until the completion of 40 weeks of pregnancy. If the user&#39;s input for the week-and-day counter  30  indicates that the current date is in the last 99 days of the pregnancy, the device  10  may additionally display the count-down days on the day counter  32  as illustrated in  FIG. 2F .  
      There may be a time delay before the device  10  automatically switches from the SetDays submode to the SetLanguage submode. The words “DAYS TO GO” or “FALTAN _DIAS” of the day counter  32  may blink to indicate the currently selected language. The user may toggle between the languages by pressing the EVENT button  12  and select one by pressing the MODE button  14 . Once a language is selected, the graphics on the windows  16 ,  18  and  20  may be displayed in the selected language.  
      When a new battery(ies) are installed in the device  10 , the device may enter into the SetLanguage submode prompting the user to select a language. The user may exit the setup mode by pressing the MODE button  14 . It should be apparent to those of ordinary skill that the device  10  may be designed to display other languages than English and Spanish. Also, the ordinary skill in the art would appreciate that the design engineer of the device  10  can easily change the shapes of the icons displayed on the display windows  16  and  18 .  
       FIG. 3  is a functional block diagram of the device  10 . The device  10  may include: a microphone  102  for receiving the fetal heartbeat sound from a Doppler instrument in the record mode; an analogue-to-digital converter  96  for converting the sound input received from the microphone  102  into a digital signal; a data memory storage (or, shortly, data storage)  94  for storing the converted digital signal; a digital-to-analogue converter  92  for converting the stored digital signal into an analogue signal; an amplifier  98  for amplifying the analogue signal received from the digital-to-analogue converter  92 ; a speaker  100  for playing the amplified analogue signal received from the amplifier  98 ; two buttons (EVENT and MODE buttons)  12 ,  14 ; a user button input sensor  90  for receiving the user&#39;s input through the two buttons  12 ,  14 ; a kick counter  86  for recording the input from the user in the kick mode ( FIG. 2A ); a timer  82  for timing events, such as kicks, and measuring the KickTime of a session; a record/playback controller  88  for controlling the length of a recorded sound and adjusting the volume-of the speaker  100 ; a mode control command recognizer  84  for receiving signals from the user button input sensor  90  and determining the current operational mode; a display screen  80 , preferably a LCD screen, masked by the front enclosure  13  to appear as three separate windows  16 ,  18  and  20 ; a power controller  74  for receiving power from a battery(ies)  72  and switching to sleep mode when the device  10  is in the idle state; and a microprocessor  76  for controlling and orchestrating the elements of the device  10  shown in  FIG. 3 . (Hereinafter, the term “audio member” may collectively refer to the speaker  100  and the microphone  102 .) It is noted that the speaker  100  may be also used as the microphone  102  and record other suitable sounds, such as a baby&#39;s first cry or words, as well as the fetal heartbeat sound. In an alternative embodiment, a solar panel may be used in place of the battery  72 .  
      The data (memory) storage  94  may also store other information including names, obstetrical data such as fetal development milestones, personal medical and emergency information, medical visits, gestational age specific recommendation, organizer, calendar, chronometer and pediatric data, such as pediatric growth chart.  
      Optionally, the device  10  may include one or more of the followings: a computer communication Input/Output  78  for exchanging information, such as the sound and kick history recorded in the device  10 , with a computer; a voice recognizer  97  for recognizing the user&#39;s voice to understand verbal commands and activating the device  10  in accordance with the commands; a built-in Doppler instrument  77  for picking up fetal heartbeat sound and playing/recording the sound; a built-in ultrasound device  73  for sensing and/or imaging fetal movement and, thereby, counting the fetal movements without or in addition/conjunction with the user&#39;s input via the EVENT button  12 ; a flash memory  91  for storing verbal instructions for use of the device  10 ; and a global positioning system (GPS)  93  for determining the user&#39;s current location and providing a navigational guidance to a destination, such as a hospital, for the user. In an alternative embodiment, the flash memory  91  may be included in the data memory storage  94 .  
      It will be appreciated by those of the ordinary skill that elements illustrated in  FIG. 3  may be modified in a variety of ways without departing from the spirit and scope of the present invention. For example, the mode control command recognizer  84  may be a firmware or software stored in the data memory storage  94  and executed by the microprocessor  76 . The kick counter  86  may be implemented and executed in the similar way. Alternatively, the kick counter  86  may be combined with the mode control command recognizer  84  prior to storage in the data memory storage  94 . In another example, the computer communication Input/Output  78  may be configured to communicate with various electronic devices, such as PDA or other suitable hand-held devices, as well as a computer.  
      The device  10  may use a conventional wireless/blue tooth technology to connect to a computer to upload or download the data stored in storage  94 . The device  10  may also incorporate an MP3, writing instrument, compact mirror, watch, clock, pendant, bracelet, key chain and software for PDA or PC.  
       FIGS. 4A-4B  show a flow chart illustrating the operational sequence of the modes depicted in connection with  FIGS. 2A-2F . The process may start in a state  202 . Next, in a state  204 , the device  10  may check if the user has selected a language. Upon negative answer to the state  204 , the process may advance to a state  258  (shown and illustrated in connection with  FIG. 4B ). Otherwise, the user may press the MODE button  14  to proceed to a state  206 .  
      The state  206  may correspond to the kick mode. If the user presses the EVENT button  12  to record a kick, the kick counter  86  ( FIG. 3 ) may determine if the kick is the first one of the current session. Upon positive answer to the state  208 , the kick counter  86  may start the Timer  82  in a state  210 , where the Timer  82  may operate to measure the KickTime of the current session. If the answer to the state  208  is negative, the process may advance to a state  212 .  
      In the state  212 , the kick counter  86  may determine if the current kick is the 10 th  kick of the current session. Upon positive answer to the state  212 , the device  10  may stop the Timer  82  and play the animation as described in connection with  FIG. 2B . The animation may include displaying the KickTime on the time display  24 , displaying a walking footprint animation  28  and playing a recorded heartbeat sound  52 . Then, the process may proceed to a state  220 . Upon negative answer to the state  212 , the kick counter  86  may increment the kick count by one. Subsequently, the process may proceed to the state  206  to cause the device  10  to stay in the kick mode.  
      If the user presses the MODE button  14  in the state  206 , the process may advance to a state  218 . In the state  218 , the device  10  may determine whether the user has logged ten KickTime records to be displayed, i.e., the user has completed ten sessions. If the device  10  has ten KickTime records stored in the data memory storage  94  ( FIG. 3 ), the process may advance to a state  220 . Otherwise the process may proceed to a state  228 .  
      The state  220  may correspond to the kick memory mode. As described in connection with  FIG. 2C , the user may press the EVENT button  12  to display the ten KickTime records one at a time. The EVENT button  12  may be used to scroll through the ten records. For each record displayed, a corresponding footprint  28  may be displayed on the kick count window  18 . The record number for the corresponding KickTime record may be displayed on the record number display  26 . Also, the time display  24  may be used to indicate the KickTime. Each time the user presses the EVENT button  12 , the kickhistory number (or equivalently, record number) may be increased by one in a state  222 . Then the process may proceed to a state  224 .  
      In the state  224 , the device  10  may determine if the current kickhistory number equals nine, i.e., the currently displayed KickTime record is the tenth one. Upon negative answer to the state  224 , the process may proceed to the state  220 . Otherwise, the kick counter  86  may reset the kickhistory number to 1. Subsequently, the process may advance to the state  220 .  
      In the state  220 , the user may press the MODE button  14  causing the process to advance to a state  228 . In the state  228 , the decision is made as to whether the data memory storage  94  ( FIG. 3 ) has any sound recording to be played. Upon negative answer to the state  228 , the process may proceed to a state  236 . Otherwise, the process may proceed to a state  230 .  
      The state  230  may correspond to the play mode. In the state  230 , the user may press the EVENT button  12 , causing the process to proceed to a state  232 . In the state  232 , the record/playback controller  88  ( FIG. 3 ) may play the recorded fetal heartbeat sound. Next, in a state  234 , the record/playback controller  88  may determine whether the play has completed. Upon positive answer to the state  234 , the process may advance to the state  236 . If the answer to the state  234  is NO, the process may proceed to the state  232 .  
      The state  236  may correspond to the record mode. In the state  236 , the user may press the EVENT button  12 , causing the process to proceed to a state  238 . In the state  238 , the record/playback controller  88  ( FIG. 3 ) may record the fetal heartbeat sound from a Doppler instrument by pressing and holding the EVENT button  12 . Next, in a state  240 , the record/playback controller  88  may determine whether the EVENT button  12  has been released. Upon positive answer to the state  240 , the process may advance to the state  228 . If the answer to the state  240  is NO, the process may proceed to the state  238 .  
      The user may press the MODE button  14  in the state  236 , causing the process to proceed to a state  242  in  FIG. 4B . The state  242  may correspond to the SetWeeks submode. In the state  242 , the user may press the EVENT button  12  causing the process to proceed to a state  244 . In the state  244 , the device  10  may increase the Weeks Pregnant in the week-and-day counter  30  by one each time the user presses the EVENT button  12 . Next, in a state  246 , a determination may be made as to whether the Weeks Pregnant is greater than forty two. Upon negative answer to the state  246 , the process may proceed to the state  242 . Otherwise, the process may advance to a state  248 . In the state  248 , the Weeks Pregnant may be set to zero. Then, the process may proceed to the state  242 . The user may press the MODE button in the state  242 , causing the process to proceed to the state  206 .  
      If the user does not press any button for a preset time interval, preferably for 10 seconds, in the state  242 , the process may proceed to a state  250 . The state  250  may correspond to the SetDays submode. In the state  250 , the user may press the EVENT button  12  causing the process to proceed to a state  252 . In the state  252 , the device  10  may increase the Days Pregnant in the week-and-day counter  30  by one each time the user presses the EVENT button  12 . Next, in a state  254 , a determination may be made as to whether the DueDays is greater than six. Upon negative answer to the state  254 , the process may proceed to the state  250 . Otherwise, the process may advance to a state  256 . In the state  256 , the Days Pregnant may be set to zero. Then, the process may proceed to the state  250 . The user may press the MODE button  14  in the state  250 , causing the process to proceed to the state  206 .  
      If the user does not press any button for a preset time interval, preferably for 10 seconds, in the state  250 , the process may proceed to a state  258 . The state  258  may correspond to the SetLanguage submode. In the state  258 , the user may press the EVENT button  12  causing the process to proceed to a state  260 . In the state  260 , the user may select a language as described in connection with  FIG. 2F . Then, the process may advance to the state  258 . The user may press the MODE button  14  in the state  258 , causing the process to proceed to the state  206 .  
       FIGS. 5A-5C  show a system flowchart shown at 300 of the device depicted in  FIG. 1A . The process may start at every 1/10 second in a state  302 , where the timer  82  ( FIG. 3 ) may provide the clock time. Next, the process may advance to a state  304 , where a determination may be made as to whether one second has elapsed. Upon positive answer to the state  304 , the progress may advance to a state  306 . In the state  306 , the device  10  may update the ProgressDays counter, where the ProgressDays collectively refer to the “Weeks and Days Pregnant” of the week-and-day counter  30  and the count-down of days-to-go of the day counter  32 . Next, in a state  308 , another determination is made as to whether the KickCount is greater than zero, i.e., the user has started recording the kicks in a session. Upon positive answer to the state  308 , the Timer may be incremented in a state  310 . Then, the process may advance to a state  312 . If the answer to the state  308  is negative or the answer to the state  304  is negative, the process may proceed to the state  312 .  
      In the state  312 , a decision may be made as to whether the current mode is the play mode. Upon positive answer to the state  312 , the process may proceed to a state  314 . In the state  314 , the user button input sensor  90  ( FIG. 3 ) may determine if the user has pressed down the EVENT button  12  for more than 0.15 seconds. If the answer to the state  314  is YES, the process may proceed to a state  316 . In the state  316 , a determination may be made as to whether the data memory storage  94  contains a heartbeat sound to be played. If the storage  94  contains a sound, the record/playback controller  88  may play the sound through the speaker  100  in a state  320 . Then, the process may proceed to a state  328  ( FIG. 5B ). If the answer to the state  316  is positive or the answer to the state  318  is negative, the process may advance to the state  328 .  
      Upon negative answer to the state  314 , the process may proceed to a state  322 . In the state  322 , the user button input sensor  90  may determine if the user has pressed down the EVENT button  12  for more than 2 seconds. If the answer to the state  322  is YES, the process may proceed to a state  324 . In the state  324 , a determination may be made as to whether the data memory storage  94  contains a heartbeat sound to be played. If the storage  94  contains a sound, the speaker volume may toggle between 25% and 100% of the maximum level in a state  326 . Then, the process may proceed to the state  328  in  FIG. 5B . Upon negative answer to the state  322 , the process may also proceed to the state  328 .  
      In the state  328 , a decision may be made as to whether the current mode is the record mode. Upon positive answer to the state  328 , the process may proceed to a state  330 . In the state  330 , a determination may be made as to whether a sound is being recorded. If the answer to the state  330  is NO, the process may proceed to a state  332 . In the state  332 , the mode control command recognizer  84  may determine if the user has pressed down the EVENT button  12  for more than 0.5 seconds. If the user has pressed down the EVENT button  12  more than 0.5 seconds, the process may proceed to a state  334  to determine whether a heartbeat sound is being played. Upon negative answer to the state  334 , the process may proceed to a state  336  to start recording a sound. Then, the process may proceed to a state  342 . If the answer to the state  332  is negative or the answer to the state  334  is positive, the process may also proceed to the state  342 .  
      Upon positive answer to the state  330 , the process may proceed to a state  338 . In the state  338 , a determination may be made as to whether the recording is more that 10 seconds. If the answer to the state  338  is YES, the process may proceed to a state  340  to stop recording. Subsequently, the process may proceed to the state  342 . If the answer to the state  328  is negative, the process may also proceed to the state  342 .  
      In the state  342 , the user button input sensor  90  ( FIG. 3 ) may determine if more than 2 seconds has elapsed since a button has been pressed. If the answer to the state  342  is YES, the process may proceed to a state  344 . In the state  344 , a determination may be made as to whether a sound is being recorded or played. If the answer to the state  344  is NO, the process may proceed to a state  346 . In the state  346 , the record/playback controller  88  may start playing audio instruction sound based on the current mode and language. Then, the process may proceed to a state  348 . If the answer to the state  342  is NO or the answer to the state  344  is YES, the process may also proceed to the state  348 .  
      In the state  348 , the user button input sensor  90  ( FIG. 3 ) may determine if more than 20 seconds has elapsed since a button has been pressed. If the answer to the state  348  is YES, the process may proceed to a state  349 . In the state  349 , a determination is made whether a recording is being played. If the answer to the state  349  is NO, the process may proceed to a state  350 . In the state  350 , a determination is made whether the current mode is the kick mode. If the answer to the state  350  is NO, the process may proceed to a state  352 . In the state  352 , the current mode is set to the kick mode. Then, the process may advance to a state  354 . If the answer to the state  348  is NO or the answer to the state  349  is YES or the answer to the state  350  is YES, the process may proceed to a state  354 .  
      In the state  354 , the display screen  80  may turn on/off the displayed words based on the current language. Next, in a state  356 , numbers of weeks and days may be displayed on the week-and-day counter  30 . Then, the process may advance to a state  358 . In the state  358 , a determination is made whether the countdown days-to-go is less than 100 and more than 2. If the answer to the state  358  is YES, the process may proceed to the state  360  to display the countdown days-to-go on the day counter  32 . Then, the process may proceed to a state  372  ( FIG. 5C ). If the answer to the state  358  is NO, the process may also proceed to the state  372 .  
      In the state  372 , a determination is made whether the current mode is the kick mode. If the answer to the state  372  is YES, the kick icon  50  ( FIG. 2A ) may be turned on (or equivalently, highlighted) in a state  374 . Subsequently, in a state  376 , footprints  28  may be displayed on the kick count window  18 . Then, the process may proceed to a state  416 . If the answer to the state  372  is NO, the process may proceed to a state  378 .  
      In the state  378 , a determination is made whether the current mode is the kick memory mode. If the answer to the state  378  is YES, the memory icon  54  ( FIG. 2C ) may be turned on in a state  380 . Subsequently, in a state  382 , the kickhistory for each KickTime record may be displayed, where the kickhistory may include a KickTime, a record number and a footprint corresponding to the record number. Then, the process may proceed to a state  416 . If the answer to the state  378  is NO, the process may proceed to a state  384 .  
      In the state  384 , a determination is made whether the current mode is the play mode. If the answer to the state  384  is YES, a determination may be made as to whether a sound is being played in a state  386 . If the answer to the state  386  is YES, the play icon  56  ( FIG. 2D ) may flash in a state  388 . Subsequently, the process may proceed to the state  416 . If the answer to the state  386  is NO, the play icon  56  may be highlighted in a state  390 . Then, the process may proceed to the state  416 . If the answer to the state  384  is NO, the process may proceed to a state  392 .  
      In the state  392 , a determination is made whether the current mode is the record mode. If the answer to the state  392  is YES, a determination may be made as to whether a sound is being recorded in a state  394 . If the answer to the state  394  is YES, a determination may be made as to whether the recording is less than 10 seconds in a state  396 . Upon positive answer to the state  396 , the process may proceed to a state  398 . In the state  398 , the record icon  58  may flash. Then, the process may proceed to the state  416 . Upon negative answer to the state  396 , the record/playback controller  88  may stop recording in a state  400 . Then, the process may proceed to the state  416 . If the answer to the state  394  is NO, the record icon  58  may be highlighted. Subsequently, the process may proceed to the state  416 . If the answer to the state  392  is NO, the process may proceed to a state  404 .  
      In the state  404 , a determination is made whether the current mode is the SetWeeks submode. If the answer to the state  404  is YES, the Weeks Pregnant of the week-and-day counter  30  flash in a state  406 . Then, the process may proceed to the state  416 . If the answer to the state  404  is NO, the process may proceed to a state  408 .  
      In the state  408 , a determination is made whether the current mode is the SetDays submode. If the answer to the state  408  is YES, the DueDays of the week-and-day counter  30  may flash in a state  410 . Then, the process may proceed to the state  416 . If the answer to the state  408  is NO, the process may proceed to a state  412 .  
      In the state  412 , a determination is made whether the current mode is the SetLanguage submode. If the answer to the state  414  is YES, the word “days to go” of the day counter  30  may flash in the current language in a state  414 . Then, the process may proceed to the state  416 . If the answer to the state  412  is NO, the process may proceed to the state  416 . In the state  416 , the process for every 0.1 second started in the state  302  in  FIG. 5A  may exit.  
       FIG. 6  is a flow chart shown at  600  illustrating the steps that may be carried out to count kicks using the device  10  according to the present invention. In a state  602 , the user of the device  10  may press the EVENT button  12  each time a fetal movement is perceived in a kick count session. Then, the device  10  may record the fetal movements up to a preset number, preferably ten, in the kick count session. During the kick count session, the device  10  may display icons on its display screen, where one additional icon is displayed each time the user presses the EVENT button  12  in a state  606 . As a consequence, the user can count the perceived fetal movements recorded in the kick count session by counting the displayed icons.  
      It should be understood, of course, that the foregoing relates to exemplary embodiments of the invention and that modifications may be made without departing from the spirit and scope of the invention as set forth in the following claims.