The Impact of Maternal Body Mass Index and Gestational Age on the Detection of Uterine Contractions by Tocodynamometry: A Retrospective Study

Aina-Mumuney, Abimbola; Hwang, Karin; Sunwoo, Nate; Burd, Irina

doi:10.1177/1933719115611754

Cited by 11 publications

(5 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The interpretation of these results remains difficult since apart from one study showing no association between BMI and nifedipine serum levels, little data exist regarding the effect of tocolysis dosage according to BMI [ 32 ]. A possible reason for the shorter intravenous tocolysis and therewith faster change to oral tocolysis in groups 2 and 3 might have been the increased difficulty of contraction monitoring by tocodynamometry with rising BMI that however did not affect GA at delivery and therewith fetal outcomes [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Fetal Spina Bifida Repair in Obese Mothers: Is Maternal and Fetal Safety Compromised?

Zepf,

Vonzun,

Rüegg

et al. 2024

Fetal Diagn Ther

View full text Add to dashboard Cite

Introduction: The MOMS-trial eligibility criteria preclude in utero surgery for fetal spina bifida (fSB) when maternal body mass index (BMI) is ≥ 35 kg/m2. Some centers still respect this criterion while others, like ours, do not. This study aims to assess whether maternal and fetal safety is compromised with higher maternal BMIs. Material and Methods: Data of 192 patients with open fSB repair at our center were retrospectively analyzed. According to their BMI, patients were divided into three groups; group 1 (BMI < 30 kg/m2), group 2 (BMI 30-35 kg/m2) and group 3 (BMI > 35 kg/m2). Subgroup analysis was performed to assess differences in maternal and fetal outcomes. Additionally, complications were divided into grades 1 to 5 according to their severity and outcome consequences and compared among groups. Results: Out of 192 patients, 146 (76.0%) had a BMI < 30 kg/m2, 28 (14.6%) had a BMI 30-35 kg/m2, and 18 (9.4%) had a BMI > 35 kg/m2. Significant differences occurring more often in either group 2 or 3 compared to group 1 were: maternal wound seroma (50% or 56% vs. 32%, p = 0.04), amniotic fluid leakage (14% or 6% vs. 2%, p = 0.01) as well as vaginal bleeding (11% or 35% vs. 9%, p = 0.01). On the contrary, duration of tocolysis with atosiban was shorter in patients with BMI > 30 kg/m2 (4 or 5 vs. 6 days, p = 0.01). When comparing severity of maternal or fetal complications, intervention-related complications grade 1 occurred significantly more often in group 3 compared to group 1 or 2 (78% vs. 45% or 57%, p = 0.02). Gestational age at delivery was around 36 weeks in all groups without significant differences. Conclusion: This investigation did not identify clinically relevant maternal and/or fetal outcome problems related to BMIs > 35 kg/m2. Additional studies are however needed to confirm our results.

show abstract

Section: Discussionmentioning

confidence: 99%

Fetal Spina Bifida Repair in Obese Mothers: Is Maternal and Fetal Safety Compromised?

Zepf,

Vonzun,

Rüegg

et al. 2024

Fetal Diagn Ther

View full text Add to dashboard Cite

show abstract

“…When patients present early in gestation for preterm labor symptoms, the desire is to determine if their complaints are due to contractions. The TOCO oftentimes misses these contractions (especially if the woman is in the midtrimester or obese) 32 and thus falsely reassures both clinician and patient. At this time, the intravaginal ring device detects occurrence and not intensity of such contractions.…”

Section: Discussionmentioning

confidence: 99%

Vaginal electrohysterography: the design and preliminary evaluation of a novel device for uterine contraction monitoring in an ovine model*

Sunwoo

Hwang

Aina-Mumuney

2015

The Journal of Maternal-Fetal & Neonatal Medicine

View full text Add to dashboard Cite

Objective Tocodynamometry is the most common method of labor evaluation but most clinicians would agree it has limited utility before 26 weeks gestation. The obesity epidemic has further reduced our ability to accurately detect uterine contractions using the tocodynamometer at any gestational age. We sought to design and test a novel contraction monitor that bypasses the maternal abdomen. Methods An optimized version of an intravaginal electrohysterographic ring device was tested in an ovine model. The device and its methodology as well as the tocodynamometer were validated against the current gold standard uterine activity monitor, the intrauterine pressure catheter in 6 sheep at varying gestational ages. Results Both the intravaginal ring device and the tocodynamometer correlated well with IUPC, r = 0.69 and 0.73 respectively (p<0.001). The number of contractions detected by each monitor remained similar even after accounting for confounders. Conclusions These results suggest that uterine activity can be monitored from the vaginal interface in an ovine model and offers an alternative clinical tool for the detection of contractions in situations in which tocodynamometry would be ineffective or intrauterine monitoring inappropriate.

show abstract

“…[8][9][10] Keadaan ini berarti tokodinamometer yang digunakan pada penelitian ini menunjukkan sensitivitas, spesifisitas dan juga akurasi yang mendekati terhadap kardiotokografi sebagai 18 Penelitian ini juga sesuai dengan penelitian yang dilakukan oleh Aina-Mumuney dkk. 19 tokodinamometer efektif digunakan pada IMT yang normal, pengukuran kontraksi uterus perlu memperhatikan peningkatan IMT seorang ibu seiring dengan peningkatan usia kehamilan.…”

Section: Pembahasanunclassified

Sensitivitas, Spesifisitas dan Akurasi Pengukuran Kontraksi Uterus Kala I Fase Aktif Ibu Bersalin Menggunakan Tokodinamometer

Bainuan

Husin

Anwar

et al. 2018

mkb

View full text Add to dashboard Cite

AbstrakPada umumnya pemeriksaan kontraksi uterus dilakukan dengan menekan fundus uteri, namun demikian cara tersebut menyebabkan ketidaknyamanan dan hanya dapat mengetahui frekuensi kontraksi sedangkan durasi dan intensitas kontraksi pengukurannya bersifat subjektif. Cara lain yang digunakan adalah menggunakan Kardiotokografi, namun harganya mahal danl lebih sulit untuk menginterpretasikan hasil. Tokodinamometer dapat digunakan untuk menilai kemajuan persalinan karena dapat dibaca langsung, sederhana, dan harga terjangkau sehingga dapat digunakan di komunitas. Penelitian ini bertujuan mengukur sensitivitas, spesifisitas, dan akurasi tokodinamometer dalam mengukur kontraksi uterus kala I fase aktif pada ibu bersalin. Rancangan penelitian merupakan studi observasional analitik dengan desain potong lintang. Sampel penelitian berjumlah 47 orang yang memenuhi kriteria inklusi di Rumah Sakit Khusus Ibu dan Anak Kota Bandung dengan teknik concecutive sampling. Pengambilan data dengan mengukur kontraksi uterus menggunakan tokodinamometer dan kardiotokografi (KTG) diukur secara bersamaan sebanyak 2 kali. Analisis menggunakan uji Wilcoxon dan uji diagnostik. Hasil penelitian didapatkan, frekuensi dan intensitas kontraksi uterus tidak terdapat perbedaan (p>0,05), sedangkan durasi kontraksi terdapat perbedaan bermakna (p<0,05) antara ibu bersalin kala I fase aktif yang diukur menggunakan tokodinamometer dan KTG. Tokodinamometer memiliki nilai sensitivitas (90,47 %), spesifisitas (78,26 %), dan akurasi (87,21 %). Simpulan, tokodinamometer dapat digunakan untuk pemantauan kontraksi uterus di komunitas. Kata kunci : Fase aktif, kontraksi uterus, tokodinamometerSensitivity, Specificity and Accuracy Measurement of Kala I Uterus Contraction Maternity Active Maternal Phase using Tocodynamometer Abstract Examination of uterine contractions is generally done by pressing the uterine fundus. This method can cause discomfort and can only know the frequency of contraction while the duration and intensity of contraction measurement is subjective so as to cause imprecise in making decisions early during labor. Labor monitoring should use cardiotocography, but it is expensive, more difficult to interpret results. Though contraction assessment is important to assess the progress of labor, so that needed tools that can be used in the community. This study aimed to analyze the sensitivity, specificity and accuracy of tocodynamometer in measuring uterine contraction in the first stage on the active phase of parturient. The research design is an analytic observational study with Cross sectional design. The sample of this research were 47 people who fulfill the inclusion criteria at RSKIA Bandung, with concecutive sampling technique. Intake of data by measuring uterine contractions using tocodynamometer and cardiotocography measured simultaneously as much as 2 times or according to mother condition. The analysis used the Wilcoxon's test, and the diagnostic test. The results showed that the frequency and intensity of uterine contractions did not ...

show abstract

The Impact of Maternal Body Mass Index and Gestational Age on the Detection of Uterine Contractions by Tocodynamometry: A Retrospective Study

Cited by 11 publications

References 17 publications

Fetal Spina Bifida Repair in Obese Mothers: Is Maternal and Fetal Safety Compromised?

Fetal Spina Bifida Repair in Obese Mothers: Is Maternal and Fetal Safety Compromised?

Vaginal electrohysterography: the design and preliminary evaluation of a novel device for uterine contraction monitoring in an ovine model*

Sensitivitas, Spesifisitas dan Akurasi Pengukuran Kontraksi Uterus Kala I Fase Aktif Ibu Bersalin Menggunakan Tokodinamometer

Contact Info

Product

Resources

About