Benalcazar-Parra Carlos, Ye-Lin Yiyao, Garcia-Casado Javier, Monfort-Orti Rogelio, Alberola-Rubio Jose, Perales Alfredo, Prats-Boluda Gema
Centro de Investigación e Innovación en Bioingeniería, Universitat Politècnica de València, Edif. 8B, Camino de Vera SN, 46022 Valencia, Spain.
Servicio de Obstetricia y Ginecología, Hospital Universitario y Politécnico La Fe de Valencia, Valencia, Spain.
Med Eng Phys. 2018 Jun;56:27-35. doi: 10.1016/j.medengphy.2018.04.002. Epub 2018 Apr 23.
Labor induction is a common practice to promote uterine contractions and labor onset. Uterine electrohysterogram (EHG) has proved its suitability for characterizing the uterus electrophysiological condition in women with spontaneous labor. The aim of this study was to characterize and compare uterine myoelectrical activity during the first 4 h in response to labor induction drugs, Misoprostol (G1) and Dinoprostone (G2), by analyzing the differences between women who achieved active phase of labor and those who did not (successful and failed inductions). A set of temporal, spectral and complexity parameters were computed from the EHG-bursts. As for successful inductions, statistical significant and sustained increases with respect to basal period were obtained for EHG amplitude, mean frequency, uterine activity index (UAI) and Teager, after 60' for the G1 group; duration, amplitude, number of contractions and UAI for the G2 group, after 120'. Moreover, Teager showed statistical significant and sustained differences between successful and failed inductions (1.43 ± 1.45 µVHz10 vs. 0.40 ± 0.26 µVHz10 after 240') for the G1 group, but not in the G2 group, probably due to the slower pharmacokinetics of this drug. These results revealed that EHG could be useful for successful induction prediction in the early stages of induction, especially when using Misoprostol.
引产是促进子宫收缩和发动分娩的常见操作。子宫电图(EHG)已证明其适用于表征自然分娩女性的子宫电生理状况。本研究的目的是通过分析进入活跃期分娩的女性与未进入活跃期分娩的女性(引产成功与失败)之间的差异,来表征和比较在引产药物米索前列醇(G1)和地诺前列酮(G2)作用下最初4小时内的子宫肌电活动。从EHG爆发中计算出一组时间、频谱和复杂度参数。对于引产成功的情况,G1组在60分钟后,EHG振幅、平均频率、子宫活动指数(UAI)和Teager相对于基础期有统计学显著且持续的增加;G2组在120分钟后,持续时间、振幅、宫缩次数和UAI有增加。此外,G1组在240分钟后,成功与失败引产之间Teager显示出统计学显著且持续的差异(1.43±1.45µVHz10 vs.0.40±0.26µVHz10),但G2组没有,这可能是由于该药物的药代动力学较慢。这些结果表明,EHG可用于引产早期成功引产的预测,尤其是在使用米索前列醇时。