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未产妇分娩时子宫和腹部肌肉肌电活动的同步记录与分析

Simultaneous Recording and Analysis of Uterine and Abdominal Muscle Electromyographic Activity in Nulliparous Women During Labor.

作者信息

Qian Xueya, Li Pin, Shi Shao-Qing, Garfield Robert E, Liu Huishu

机构信息

1 Department of Obstetrics, First Affiliated Hospital of Jinan University, Guangzhou, China.

2 Department of Obstetrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.

出版信息

Reprod Sci. 2017 Mar;24(3):471-477. doi: 10.1177/1933719116658704. Epub 2016 Jul 19.

Abstract

OBJECTIVE

To record and characterize electromyography (EMG) from the uterus and abdominal muscles during the nonlabor to first and second stages of labor and to define relationships to contractions.

METHODS

Nulliparous patients without any treatments were used (n = 12 nonlabor stage, 48 during first stage and 33 during second stage). Electromyography of both uterine and abdominal muscles was simultaneously recorded from electrodes placed on patients' abdominal surface using filters to separate uterine and abdominal EMG. Contractions of muscles were also recorded using tocodynamometry. Electromyography was characterized by analysis of various parameters.

RESULTS

During the first stage of labor, when abdominal EMG is absent, uterine EMG bursts temporally correspond to contractions. In the second stage, uterine EMG bursts usually occur at same frequency as groups of abdominal bursts and precede abdominal bursts, whereas abdominal EMG bursts correspond to contractions and are accompanied by feelings of "urge to push." Uterine EMG increases progressively from nonlabor to second stage of labor.

CONCLUSIONS

(1) Uterine EMG activity can be separated from abdominal EMG events by filtering. (2) Uterine EMG gradually evolves from the antepartum stage to the first and second stages of labor. (3) Uterine and abdominal EMG reflect electrical activity of the muscles during labor and are valuable to assess uterine and abdominal muscle events that control labor. (4) During the first stage of labor uterine, EMG is responsible for contractions, and during the second stage, both uterine and abdominal muscle participate in labor.

摘要

目的

记录并描述非分娩期至分娩第一和第二阶段子宫及腹部肌肉的肌电图(EMG),并确定其与宫缩的关系。

方法

使用未接受任何治疗的初产妇(非分娩期12例,第一产程48例,第二产程33例)。通过放置在患者腹部表面的电极同时记录子宫和腹部肌肉的肌电图,使用滤波器分离子宫和腹部肌电图。还使用宫缩图记录肌肉收缩情况。通过分析各种参数对肌电图进行特征描述。

结果

在分娩第一阶段,腹部肌电图不存在时,子宫肌电图爆发在时间上与宫缩相对应。在第二阶段,子宫肌电图爆发通常与腹部爆发组频率相同且先于腹部爆发,而腹部肌电图爆发与宫缩相对应并伴有“推挤冲动”感。子宫肌电图从非分娩期到分娩第二阶段逐渐增加。

结论

(1)通过滤波可将子宫肌电图活动与腹部肌电图事件分离。(2)子宫肌电图从产前阶段逐渐发展到分娩第一和第二阶段。(3)子宫和腹部肌电图反映分娩期间肌肉的电活动,对评估控制分娩的子宫和腹部肌肉事件有价值。(4)在分娩第一阶段,子宫肌电图引发宫缩,在第二阶段,子宫和腹部肌肉均参与分娩。

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