ResearchObstetricsSpatiotemporal electrohysterography patterns in normal and arrested labor
Section snippets
Materials and Methods
We conducted a case-control study using data derived from a larger study designed to noninvasively collect fetal electrocardiographic (ECG) and uterine electrical activity, represented by the electrohysterogram, or EHG. Following University of Florida College of Medicine Institutional Review Board approval, the protocol was instituted in 2001 at Shands Hospital at the University of Florida. The service consists of resident physicians supervised by faculty and fellows. All patients admitted for
Results
The average duration of arrest in the cesarean delivery cohort was 6 ± 3 hours. All arrest patients and 17/24 vaginally delivered patients received oxytocin augmentation. All patients had a sustained contraction frequency of every 1-3 minutes, and of the 11 cesarean patients who had intrauterine pressure (IUP) monitoring, all achieved Montevideo units (MVU) > 150 mmHg. The groups were not significantly different with regard to the pairing variables (gestational age, BMI, dilation at
Comment
Intrapartum assessment of uterine activity is routinely employed to guide active management of labor and delivery. The goal of such management is 2-fold: (1) progress in labor resulting in vaginal delivery, and (2) identification of unsuccessful labor that requires cesarean delivery. While the gold standard for assessing labor progress is serial cervical examinations, the risk of infection coupled with the inherent inaccuracy of the measure limits its use for assessment at intervals of less
Acknowledgments
The authors are grateful to Keith Muller, PhD, J. R. Clemmons, and Q. Li for statistical analyses. Dr Muller is Professor and Director of the Division of Biostatistics, Department of Epidemiology and Health Policy Research, University of Florida College of Medicine. Mr Clemmons and Ms Li are Coordinators, Statistical Research, Institute for Child Health Policy, University of Florida. The authors are also grateful to Laura Tripp, RN, and Erin Tighe for their data collection and research
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Multi-channel electrohysterography enabled uterine contraction characterization and its effect in delivery assessment
2023, Computers in Biology and MedicineMonitoring uterine contractions during labor: current challenges and future directions
2023, American Journal of Obstetrics and GynecologyQuantitative analysis for grading uterine electromyography activities during labor
2023, American Journal of Obstetrics and Gynecology MFMCitation Excerpt :EMG activity was also reflective of the frequency and intensity of uterine contraction. Recent advances in EMG have therefore been applied in both clinical practice and research, including the prediction of preterm birth,5,6 parturition,7,8 and labor arrest9,10 and the evaluation of the effects of tocolysis,11–14 oxytocin,10 and patient-controlled epidural analgesia (PCEA)15–17on EMG activities and outcomes in labor. EMG is recognized as an effective means of pregnancy and delivery monitoring, but it is still not widely used in the clinical setting.
Regional identification of information flow termination of electrohysterographic signals: Towards understanding human uterine electrical propagation
2022, Computer Methods and Programs in BiomedicineA study of uterine inertia on the spontaneous of labor using uterine electromyography
2021, Taiwanese Journal of Obstetrics and GynecologyCitation Excerpt :Thus, the physiological control of uterine contractile events is important in understanding this condition. Uterine contractility is recognized as being regulated by excitability of the muscle of the uterus (myometrium) and movement of charged ions between the interior and exterior muscle cells to produce voltage changes (bursts) that propagate throughout the uterus to produce synchronization of contractility. [16–18] Contractions of the myometrium are directly related to electrical bursts within the muscle cells [16].
Performance comparison of coupling-evaluation methods in discriminating between pregnancy and labor EHG signals
2021, Computers in Biology and MedicineCitation Excerpt :Our results generally coincide with other study results (except one) regarding the increasing connectivity trend from pregnancy to labor. Regarding the direction of propagation, our results coincide with [16,17] that show multi-directionality with a concentration towards the cervix (bottom), partially coincide with [11,20] that indicates both upward and downward propagation direction, and also with [15] that found no preferred propagation direction. One of the limitations of our study is that the proposed filtering-windowing framework is not suitable for real-time applications as the entire contraction signal must be present prior to starting stationary segmentation preprocessing.
Cite this article as: Euliano TY, Marossero D, Nguyen MT, et al. Spatiotemporal electrohysterography patterns in normal and arrested labor. Am J Obstet Gynecol 2009;200:54.e1-54.e7.
Reprints not available from authors.
This material is based upon work supported by the National Science Foundation under Grant No. DMI-0239060.
Dr N. R. Euliano is president, and Ms Marossero and Mr Nguyen are employees of Convergent Engineering. Drs T. Y. Euliano and N. R. Euliano, Ms Marossero, and Dr Principe are listed on patents filed for some of the technology described in this paper.