A comparison of surface acquired uterine electromyography and intrauterine pressure catheter to assess uterine activity

Haran, Gabi; Elbaz, Meyer; Fejgin, Moshe D.; Biron‐Shental, Tal

doi:10.1016/j.ajog.2011.12.015

Cited by 43 publications

(19 citation statements)

References 25 publications

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“…11 Several groups, including our own, have reported the superiority of EHG over Toco, 5,7,9 especially in the obese. 12 Although contraction amplitude does not directly correlate between EHG and IUPC, 6 a relationship does exist [13][14][15][16] that could be used to generate comparable tracings. Clinically, labor monitoring largely remains a visual interpretation of segments that pair UA and fetal heart rate.…”

Section: Discussionmentioning

confidence: 99%

Monitoring Uterine Activity during Labor: Clinician Interpretation of Electrohysterography versus Intrauterine Pressure Catheter and Tocodynamometry

Euliano¹,

Nguyen²,

Darmanjian

et al. 2016

Amer J Perinatol

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Objective The aim of this article was to compare clinical interpretation of uterine activity tracings acquired by tocodynamometry and electrohysterography with the gold standard, intrauterine pressure. Study Design Using data from a previous study, subjects who had simultaneous monitoring with all three uterine activity devices were included in this study. These were parturients who required intrauterine pressure catheter (IUPC) placement for obstetric indication. A Web-based application displayed scrolling 30-minute segments of uterine activity. Two blinded obstetricians and two blinded obstetric nurses independently reviewed the segments, marking uninterpretable segments and the peak of each contraction. Interpretability was compared using positive percent agreement. False positives are contractions marked in the noninvasive strip that have no corresponding contraction in the IUPC strip. False negatives are the reverse. Results A total of 135 segments, acquired during either Stage 1 (active labor) or Stage 2 (pushing), from 105 women, were included in this analysis. For all four observers, both interpretability and sensitivity of electrohysterography exceeded that of tocodynamometry (p < 0.0001). This remained true for the obese population (96 segments). Conclusion Compared with the IUPC, electrohysterography is more sensitive and provides tracings that are more often interpretable than tocodynamometry for intrapartum monitoring; electrohysterography is also less affected by increasing maternal body mass index.

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Section: Discussionmentioning

confidence: 99%

Monitoring Uterine Activity during Labor: Clinician Interpretation of Electrohysterography versus Intrauterine Pressure Catheter and Tocodynamometry

Euliano¹,

Nguyen²,

Darmanjian

et al. 2016

Amer J Perinatol

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“…They reflect the continuous de- and repolarization of the cell membranes, and therefore also the contraction of the muscle cells, making it a good marker for uterine activity. [10]–[12] The uterine electrical activity appears in bursts, each corresponding to a contraction. A burst is seen as a low frequency (<1 Hz) oscillating signal that can last more than a minute.…”

Section: Introductionmentioning

confidence: 99%

Velocity and Directionality of the Electrohysterographic Signal Propagation

et al. 2014

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ObjectiveThe initiation of treatment for women with threatening preterm labor requires effective distinction between true and false labor. The electrohysterogram (EHG) has shown great promise in estimating and classifying uterine activity. However, key issues remain unresolved and no clinically usable method has yet been presented using EHG. Recent studies have focused on the propagation velocity of the EHG signals as a potential discriminator between true and false labor. These studies have estimated the propagation velocity of individual spikes of the EHG signals. We therefore focus on estimating the propagation velocity of the entire EHG burst recorded during a contraction in two dimensions.Study DesignEHG measurements were performed on six women in active labor at term, and a total of 35 contractions were used for the estimation of propagation velocity. The measurements were performed using a 16-channel two-dimensional electrode grid. The estimates were calculated with a maximum-likelihood approach.ResultsThe estimated average propagation velocity was 2.18 (±0.68) cm/s. No single preferred direction of propagation was found.ConclusionThe propagation velocities estimated in this study are similar to those reported in other studies but with a smaller intra- and inter-patient variation. Thus a potential tool has been established for further studies on true and false labor contractions.

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“…While the current technology has not been validated to monitor strength, there are preliminary data showing promise for strength monitoring. [27][28][29][30][31][32][33][34][35] With the continued development of this technology, a move toward less invasive monitoring with avoidance of IUPC may be warranted.…”

Section: Discussionmentioning

confidence: 99%

Intrauterine Pressure Catheter Use Is Associated with an Increased Risk of Postcesarean Surgical Site Infections

et al. 2019

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Objective This study aimed to determine if intrapartum placement of an intrauterine pressure catheter (IUPC) is associated with an increased rate of surgical site infections in women undergoing a cesarean delivery. Study Design This was a secondary analysis of the prospective observational Maternal–Fetal Medicine Units Network Vaginal Birth after Cesarean Registry. We compared patients with and without IUPC use. A multivariable logistic regression was performed to evaluate for an association between IUPC use and postcesarean surgical site infections. Results The study included 16,887 women: 7,441 with IUPC use and 9,446 without IUPC use. After adjustment for potential cofounders, IUPC use was associated with an increased risk of postcesarean infections compared with those without IUPC use (adjusted odds ratio: 1.28; 95% confidence interval: 1.10–1.50; p = 0.002). Conclusion IUPC use is associated with an increased risk of postcesarean surgical site infections. This supports the judicious use of IUPC for limited clinical indications and provides a potential area of focus for reduction in postcesarean infections.

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A comparison of surface acquired uterine electromyography and intrauterine pressure catheter to assess uterine activity

Cited by 43 publications

References 25 publications

Monitoring Uterine Activity during Labor: Clinician Interpretation of Electrohysterography versus Intrauterine Pressure Catheter and Tocodynamometry

Monitoring Uterine Activity during Labor: Clinician Interpretation of Electrohysterography versus Intrauterine Pressure Catheter and Tocodynamometry

Velocity and Directionality of the Electrohysterographic Signal Propagation

Intrauterine Pressure Catheter Use Is Associated with an Increased Risk of Postcesarean Surgical Site Infections

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