Electrohysterography for uterine monitoring during term labour compared to external tocodynamometry and intra-uterine pressure catheter

Vlemminx, Marion W.C.; Thijssen, Kirsten M.J.; Bajlekov, Galin I.; Dieleman, Jeanne P.; Jagt, M.B. van der Hout-van der; Oei, S.G.

doi:10.1016/j.ejogrb.2017.05.027

Cited by 44 publications

(34 citation statements)

References 25 publications

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“…However, visual assessment of the remaining 2 registrations showed high agreement, in both first and second stages of labor. Previous research has shown that the EHG technology performs better than TOCO during the first stage of labor in non‐obese and obese women 15 . Furthermore, the technology is preferred by women compared with conventional technologies for UA monitoring 29 …”

Section: Discussionmentioning

confidence: 99%

“…Due to the rare reported risks of the IUPC, it is not routinely applied during labor and in some hospitals only used on indication 13,14 . As the EHG algorithm incorporated in this NI‐fECG device is an improved version of a previously validated technology, 15 we believe that this limited number of IUPC registrations would be sufficient for validation of contraction monitoring.…”

Section: Methodsmentioning

confidence: 99%

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Intrapartum non‐invasive electrophysiological monitoring: A prospective observational study

Lempersz

Noben

Osta³

et al. 2020

Acta Obstet Gynecol Scand

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Introduction Doppler ultrasound cardiotocography is a non‐invasive alternative that, despite its poor specificity, is often first choice for intrapartum monitoring. Doppler ultrasound suffers from signal loss due to fetal movements and is negatively correlated with maternal body mass index (BMI). Reported accuracy of fetal heart rate monitoring by Doppler ultrasound varies between 10.6 and 14.3 bpm and reliability between 62.4% and 73%. The fetal scalp electrode (FSE) is considered the reference standard for fetal monitoring but can only be applied after membranes have ruptured with sufficient cervical dilatation and is sometimes contra‐indicated. A non‐invasive alternative that overcomes the shortcomings of Doppler ultrasound, providing reliable information on fetal heart rate, could be the answer. Non‐invasive fetal electrocardiography (NI‐fECG) uses a wireless electrode patch on the maternal abdomen to obtain both fetal and maternal heart rate signals as well as an electrohysterogram. We aimed to validate a wireless NI‐fECG device for intrapartum monitoring in term singleton pregnancies, by comparison with the FSE. Material and methods We performed a multicenter cross‐sectional observational study at labor wards of 6 hospitals located in the Netherlands, Belgium, and Spain. Laboring women with a healthy singleton fetus in cephalic presentation and gestational age between 36 and 42 weeks were included. Participants received an abdominal electrode patch and FSE after written informed consent. Accuracy, reliability, and success rate of fetal heart rate readings were determined, using FSE as reference standard. Analysis was performed for the total population and measurement period as well as separated by labor stage and BMI class (≤30 and >30 kg/m2). Results We included a total of 125 women. Simultaneous registrations with NI‐fECG and FSE were available in 103 women. Overall accuracy is −1.46 bpm and overall reliability 86.84%. Overall success rate of the NI‐fECG is around 90% for the total population as well as for both BMI subgroups. Success rate dropped to 63% during second stage of labor, similar results are found when looking at the separate BMI groups. Conclusions Performance measures of the NI‐fECG device are good in the overall group and the separate BMI groups. Compared with Doppler ultrasound performance measures from the literature, NI‐fECG is a more accurate alternative. Especially, when women have a higher BMI, NI‐fECG performs well, resembling FSE performance measures.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Intrapartum non‐invasive electrophysiological monitoring: A prospective observational study

Lempersz

Noben

Osta³

et al. 2020

Acta Obstet Gynecol Scand

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“…The sample size of 52 patients was based on a power analysis to validate the sensitivity of EHG, reported in our previous publication. 5 We used SPSS (Statistical Package for Social Science) 23 statistics (IBM, New York, USA) for statistical evaluation. Descriptive statistics included frequencies with percentages and 95% confidence intervals (CI) for categorical data, 12 13 mean with standard deviation (SD) for normally distributed continuous variables, or median with interquartile range (IQR) for nonnormally distributed continuous variables.…”

Section: Methodsmentioning

confidence: 99%

“…These techniques are compared in several studies that mainly focus on diagnostic values, interpretability, and labor outcomes. 1 2 3 4 5 Only 1 article describes patients' and users' (i.e., healthcare provider) satisfaction of 2 securing methods (belts), both concerning external TOCO devices. 6 Reports on users' and patients' preferences of all 3 uterine monitoring methods are still missing, while this topic is becoming more important nowadays.…”

mentioning

confidence: 99%

“…In a separate paper, we described a study with simultaneous recordings of EHG, TOCO, and IUPC. 5 Apart from the presented test characteristics, we wanted to gain insight into the patients' and users' preferences and characteristics, as well as they should be considered, when opting for uterine monitoring techniques. We hypothesize that both patients and users prefer EHG, since this method is noninvasive and less influenced by maternal movements.…”

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confidence: 99%

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Uterine Monitoring Techniques from Patients' and Users' Perspectives

Thijssen

Vlemminx

Westerhuis

et al. 2018

AJP Rep

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Objective To evaluate preferences from patients and users on 3 uterine monitoring techniques, during labor. Study Design 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. Nurses completed a questionnaire evaluating users' preferences. Results Of all 52 participating women, 80.8% preferred the electrohysterograph, 17.3% the intrauterine pressure catheter and 1.9% the external tocodynamometer. For these women, the electrohysterograph scored best regarding application and presence during labor ( p < 0.001). Most important aspects were “least likely to harm” and “least discomfort”. Of 57 nurses, 40.4% preferred the electrohysterograph, 35.1% the external tocodynamometer, and 24.6% had no preference, or replied that their preference is subject to situation and patient. Conclusion Patients prefer the electrohysterograph over the external tocodynamometer and the intrauterine pressure catheter, while healthcare providers report ambiguous results.

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M-mode Ultrasound Scan as a Potential Alternative Technique for Monitoring Uterine Contractions in Obese Patients

İnce

Karaca

2021

Reprod. Sci.

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Electrohysterography for uterine monitoring during term labour compared to external tocodynamometry and intra-uterine pressure catheter

Abstract: Electrohysterography has a higher sensitivity for uterine contraction detection than external tocodynamometry during first stage of labour, in non-obese and obese women. Electrohysterography identifies more contractions than conventional techniques.

Cited by 44 publications

References 25 publications

Intrapartum non‐invasive electrophysiological monitoring: A prospective observational study

Intrapartum non‐invasive electrophysiological monitoring: A prospective observational study

Uterine Monitoring Techniques from Patients' and Users' Perspectives

M-mode Ultrasound Scan as a Potential Alternative Technique for Monitoring Uterine Contractions in Obese Patients

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