Monitoring contractions during labour using the external tocodynamometer can be difficult or even impossible, and using the invasive intrauterine pressure catheter is associated with rare but serious complications. A new non-invasive technique is currently available: electrohysterography (EHG). This technique converts the electrical activity of the uterine muscle into a legible tocogram. The EHG signal has a high correlation with the intra-uterine pressure and provides a more accurate assessment of uterine activity compared to external tocodynamometry. EHG is suitable for women in labour with failure of the external tocodynamometer. In clinical practice EHG also appeared to report a more detailed tocographic waveform, like hypertonia or unorganized electrical uterine activity. However, its signal quality depends on adequate skin preparation and correct positioning of the electrodes on the maternal abdomen. Hence, with electrohysterography as non-invasive alternative for uterine monitoring, choosing between safety and accuracy is no longer necessary.
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J Midwifery Womens Health
November 2023
Obstetrics and Gynecology, Brody School of Medicine, East Carolina University, Greenville, North Carolina.
Introduction: Highly sensitive, external uterine electromyography (EMG) measures myometrial electrical activity and is noninvasive compared with the clinical intrauterine pressure catheter. Most experimental studies have measured EMG in 30-minute epochs, limiting the utility of this instrumentation in intrapartum clinical practice. To test proof of concept, surface uterine EMG contraction activity was continuously collected throughout the first stage of labor from healthy women at term gestation with (n = 3) and without (n = 1) epidural or combined spinal-epidural analgesia for a maximal length of 11 hours and 24 minutes.
View Article and Find Full Text PDFAm J Perinatol
February 2024
Department of Obstetrics and Gynecology, University of Arizona College of Medicine, Tucson, Arizona.
Objective: The objective of this study was to compare performance of a maternal surface electrode patch with ultrasound- and tocodynamometer-based monitoring to detect fetal heart rate and uterine contractility in late preterm labors.
Study Design: Thirty women between 34 and 36 weeks' gestation were monitored simultaneously with a Doppler/tocodynamometer system and a wireless fetal-maternal abdominal surface electrode system. Fetal and maternal heart rate and uterine contraction data from both systems were compared.
Eur J Obstet Gynecol Reprod Biol
December 2020
Department of Obstetrics and Gynecology, Máxima MC, P.O. Box 7777, 5500 MB, Veldhoven, the Netherlands; Department of Electrical Engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB, Eindhoven, the Netherlands; Eindhoven MedTech Innovation Center (e/MTIC), Eindhoven, the Netherlands.
Objective: The aim of this research was to assess the quality and inter- and intra-observer agreement of tracings obtained by three different techniques for uterine contraction monitoring: the external tocodynamometer (TOCO), the intrauterine pressure catheter (IUPC) and a recently introduced method based on electrohysterography (EHG).
Study Design: We included 150 uterine activity registrations from a previous prospective observational study (W3 study), conducted at Máxima Medical Centre in Veldhoven, the Netherlands. Term singleton pregnant women were simultaneously monitored with TOCO, IUPC and EHG during labor.
AJP Rep
July 2018
Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, the Netherlands.
To evaluate preferences from patients and users on 3 uterine monitoring techniques, during labor. Women in term labor were simultaneously monitored with the intrauterine pressure catheter, the external tocodynamometer, and the electrohysterograph. Postpartum, these women filled out a questionnaire evaluating their preferences and important aspects.
View Article and Find Full Text PDFObstet Gynecol Surv
May 2018
Gynecologist-Perinatologist, Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, the Netherlands; and Professor Fundamental Perinatology, Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands.
Importance: Real-time electrohysterography (EHG)-based technologies have recently become available for uterine monitoring during term labor. Therefore, obstetricians need to be familiar with the diagnostic value, advantages, and limitations of using EHG.
Objective: The aims of this study were to determine the diagnostic value of EHG in comparison to (1) the intrauterine pressure catheter (IUPC), (2) the external tocodynamometer (TOCO), and (3) in case of maternal obesity; (4) to evaluate EHG from users' and patients' perspectives; and (5) to assess whether EHG can predict labor outcome.
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