Donati F, Ferraris F, Rustichelli S, Gagliardi L
J Perinat Med. 1976;4(4):242-54. doi: 10.1515/jpme.1976.4.4.242.
In recent years many authors have considered evaluation of uterine contractility by means of analysis of amniotic fluid pressure variations. The reason for this is the introduction in obstetrical management of equipment for the recording of amniotic fluid pressure variations which is a powerful facility for clinical investigation, particularly, if it is considered that previous research has been based upon clinical evaluations and measurements carried out by extra and intra-uterine manometers. Important results of these studies are the definitions of two labor indices, the Montevideo unit (defined as the sum of the maxima of the pressure signal of all uterine contractions during a time interval of ten minutes) and the Alexandria unit (which also takes into account the duration of the contraction:this unit corresponds to the Montevideo unit multiplied by the mean value of the duration of the considered contractions). It is very difficult, however, in fact almost impossible, to summarize the evaluation of labor as the only indes. Many parameters which characterize the shape, frequency and tone of contraction patterns, may be themselves important and could indicated the presence of pathological elements. At present it is not well known which parameters are useful. Since many different sets of parameters can be chosen to characterize the signal, the first point is to determine which is more important clinically. The aim of this paper is to study a procedure of intrauterine pressure signal analysis, which allows the description of uterine contraction by a set of parameters that is interesting for research purposes during labor and suitable for continuous monitoring. The set of parameters was chosen in order to repeat quantitatively the qualitative analysis which a physician can make by a simple inspection of the pressure signal oscillogram. Visual examination of the tocograph results is a clumsy means for evaluating labor performed by an experienced physician. It may appear that the pressure starts "suddenly" (or not) to increase and rises "quickly" (or "slowly"), then it maintains "high" (or "low") mean values for a "long" (or "short") time, with "smooth" (or "irregular") behaviour, then it decreases "quickly" (or slowly, until "suddenly" (or "smoothly") it reaches its basal level, whd the beginning of another uterine contraction is "long" (or "short", during this time the pressure is "almost" constant (or has a "drift" and/or presents "many irregularities"). Therefore the 25 chosen parameters replace quantitatively the above qualitative evaluations. These parameters are not put forward to indicate directly the presence of pathological facttor, but summarize all the interesting clinical aspects of the contraction waveform for research and monitoring purposes. The parameters are extracted using a pattern recognition algorithm based on a structural representation of the contraction (Tables I, II, V)...
近年来，许多作者都考虑通过分析羊水压力变化来评估子宫收缩力。这样做的原因是产科管理中引入了记录羊水压力变化的设备，这是一种强大的临床研究工具，特别是当我们考虑到以往的研究是基于子宫内外压力计进行的临床评估和测量时。这些研究的重要成果是定义了两个产程指标，即蒙得维的亚单位（定义为十分钟时间间隔内所有子宫收缩压力信号最大值之和）和亚历山大单位（它还考虑了收缩持续时间：该单位等于蒙得维的亚单位乘以所考虑收缩持续时间的平均值）。然而，实际上几乎不可能将产程评估仅概括为单一指标。许多表征收缩模式形状、频率和张力的参数本身可能很重要，并且可能表明存在病理因素。目前尚不清楚哪些参数是有用的。由于可以选择许多不同的参数集来表征信号，首要问题是确定哪个在临床上更重要。本文的目的是研究一种子宫内压力信号分析程序，该程序允许通过一组参数来描述子宫收缩，这组参数对于产程研究很有意义且适合连续监测。选择这组参数是为了定量重复医生通过简单检查压力信号波形图所进行的定性分析。对于经验丰富的医生来说，通过目视检查宫缩图结果来评估产程是一种笨拙的方法。可能会出现压力“突然”（或并非如此）开始升高，“快速”（或“缓慢”）上升，然后在“长”（或“短”）时间内保持“高”（或“低”）平均值，表现为“平稳”（或“不规则”），然后“快速”（或缓慢）下降，直到“突然”（或“平稳”）达到基础水平，而另一次子宫收缩开始时的“持续时间”是“长”（或“短”），在此期间压力“几乎”恒定（或有“漂移”和/或出现“许多不规则波动”）。因此，所选择的25个参数定量地取代了上述定性评估。这些参数并非直接用于表明病理因素的存在，而是为了研究和监测目的总结了收缩波形所有有趣的临床方面。这些参数是使用基于收缩结构表示的模式识别算法提取的（表I、II、V）……
