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[机械性和生物电子宫活动选定参数在预测先兆早产中的预后价值]

[Prognostic value of chosen parameters of mechanical and bioelectrical uterine activity in prediction of threatening preterm labour].

作者信息

Zietek Jerzy, Sikora Jerzy, Horoba Krzysztof, Matonia Adam, Jezewski Janusz, Magnucki Jacek, Kobielska Lucyna

机构信息

Katedra i Klinika Połoznictwa i Ginekologii SUM, Katowice.

出版信息

Ginekol Pol. 2009 Mar;80(3):193-200.

Abstract

OBJECTIVES

To record and analyse bioelectrical activity of the uterine muscle in the course of physiological pregnancy, labour and threatening premature labour; to define which parameters from the analysis of both electrohysterogram and mechanical activity signal allow us to predict threatening premature labour.

MATERIAL AND METHODS

Material comprised 62 pregnant women: Group I--27 patients in their first physiological pregnancy, Group II--21 patients in their first pregnancy with symptoms of threatening premature labour, and Group III--14 patients in the first labour period. The on-line analysis of the mechanical (TOCO) and electrical (EHG) contraction activity relied on determination of quantitative parameters of detected uterine contractions.

RESULTS

The obtained statistical results demonstrated a possibility to differentiate between Group I and II through the amplitude and contraction area for EHG signal, and only the contraction amplitude for TOCO signal. Additionally, significant differentiating parameters for electrohysterogram are: contraction power and its median frequency. Analyzing Group I and III, significant differences were noted for contraction amplitude and area obtained both from EHG and TOCO signals. Similarly, the contraction power (from EHG) enables us to assign the contractions either to records from Group I or to labour type. There was no significant difference noted between Group II and III.

CONCLUSIONS

Identification of pregnant women at risk of premature labour should lead to their inclusion in rigorous perinatal surveillance. This requires novel, more sensitive methods that are able to detect early symptoms of the uterine contraction activity increase. Electrohysterography provides complete information on principles of bioelectrical uterine activity. Quantitative parameters of EHG analysis enable the detection of records (contractions) with the symptoms of premature uterine contraction activity.

摘要

目的

记录并分析生理性妊娠、分娩及先兆早产过程中子宫肌肉的生物电活动;确定从子宫电图和机械活动信号分析中得到的哪些参数能够帮助我们预测先兆早产。

材料与方法

材料包括62名孕妇:第一组——27名首次生理性妊娠的患者,第二组——21名首次妊娠且有先兆早产症状的患者,第三组——14名处于第一产程的患者。对机械性(宫缩曲线)和电性(子宫电图)收缩活动的在线分析依赖于所检测到的子宫收缩定量参数的测定。

结果

所获得的统计结果表明,通过子宫电图信号的幅度和收缩面积以及宫缩曲线信号的收缩幅度可以区分第一组和第二组。此外,子宫电图的显著区分参数为:收缩力及其中位数频率。分析第一组和第三组时,发现从子宫电图和宫缩曲线信号获得的收缩幅度和面积存在显著差异。同样,收缩力(来自子宫电图)使我们能够将收缩归类为第一组记录或产程类型。第二组和第三组之间未发现显著差异。

结论

识别有早产风险的孕妇应使其纳入严格的围产期监测。这需要能够检测子宫收缩活动增加早期症状的新颖且更敏感的方法。子宫电图提供了关于子宫生物电活动原理的完整信息。子宫电图分析的定量参数能够检测出有子宫收缩活动早产症状的记录(收缩)。

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