Sunwoo Nate, Hwang Karin, Blakemore Karin J, Aina-Mumuney Abimbola
a Johns Hopkins University School of Biomedical Engineering , Baltimore , MD , USA and.
b Department of GYN/OB , Division of Maternal Fetal Medicine, Johns Hopkins School of Medicine , Baltimore , MD , USA.
J Matern Fetal Neonatal Med. 2016 Sep;29(17):2742-7. doi: 10.3109/14767058.2015.1107538. Epub 2015 Nov 23.
Tocodynamometry is the most common method of labor evaluation but most clinicians would agree it has limited utility before 26 weeks of 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.
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 six sheep at varying gestational ages.
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.
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.
宫缩图描记法是评估分娩最常用的方法,但大多数临床医生都认同在妊娠26周前其效用有限。肥胖症的流行进一步削弱了我们在任何孕周使用宫缩图描记仪准确检测子宫收缩的能力。我们试图设计并测试一种绕过孕妇腹部的新型宫缩监测仪。
在绵羊模型中测试了一种优化版的阴道内子宫电图环装置。该装置及其方法以及宫缩图描记仪,针对当前的金标准子宫活动监测仪——子宫内压力导管,在6只不同孕周的绵羊身上进行了验证。
阴道环装置和宫缩图描记仪与子宫内压力导管的相关性都很好,相关系数分别为r = 0.69和0.73(p < 0.001)。即使在考虑了混杂因素后,每个监测仪检测到的宫缩次数仍保持相似。
这些结果表明,在绵羊模型中可以从阴道界面监测子宫活动,为宫缩图描记法无效或子宫内监测不适用的情况下检测宫缩提供了一种替代临床工具。