First Affiliated Hospital of Jinan University, Guangzhou, China.
Department of Obstetrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
J Obstet Gynaecol. 2021 May;41(4):532-535. doi: 10.1080/01443615.2020.1755620. Epub 2020 Jun 4.
The objective of the study was to evaluate uterine electrical activity (EA) with EMG methods in pregnant women with complete placenta previa with preterm caesarean section (CS). This prospective study included 78 patients with complete placenta previa who were recorded for uterine EA activity from 32 to 34 weeks of gestation. The clinical and the uterine EMG burst characteristics, that are responsible for contractions, were compared between a preterm CS group (case group, = 33) and an elective control group (control group, = 45). The uterine EA burst duration was longer in the case group compared with the control group (28.79 ± 3.75 vs 19.35 ± 2.56 s; < .001). Also, the number of burst per 30 min was also higher in the case group compared with the control group (3.28 ± 0.18 vs 1.72 ± 0.22; < .001), Similarly, the RMS was higher in the case group compared with the control group (0.07 ± 0.01 vs 0.04 ± 0.01 mV; = .041). In addition, the PDS was higher in the case group compared with the control group (0.47 ± 0.03 vs 0.39 ± 0.02 Hz; = .023). This study demonstrates that women with complete placenta previa have higher uterine EA at 32-34 weeks of gestation and this is associated with a higher risk of preterm CS due to massive vaginal bleeding.IMPACT STATEMENT Antepartum massive bleeding in complete placenta previa causes maternal and foetal mortality and morbidity, currently there is no effective method to predict it. This study showed in patients with complete placenta previa who were delivered preterm via emergent caesarean section, the uterine electrical activity measured by uterine electromyography (EMG) at 32-34 weeks of gestation had an active pattern Uterine EMG is a potential tool to measure uterine electrical activity and can guide clinical management of patients with complete placenta previa, further study are needed to confirm its effectiveness in a large sample size.
本研究旨在通过肌电图（EMG）方法评估完全性前置胎盘伴早产剖宫产孕妇的子宫电活动（EA）。这项前瞻性研究纳入了 78 例完全性前置胎盘孕妇，在妊娠 32 至 34 周时记录子宫 EA 活动。比较了早产剖宫产组（病例组，n=33）和择期剖宫产对照组（对照组，n=45）的临床和子宫 EMG 爆发特征，这些特征与宫缩有关。与对照组相比，病例组子宫 EA 爆发持续时间更长（28.79±3.75 对 19.35±2.56 s；<0.001）。此外，病例组每 30 分钟的爆发次数也多于对照组（3.28±0.18 对 1.72±0.22；<0.001）。同样，病例组的均方根值（RMS）也高于对照组（0.07±0.01 对 0.04±0.01 mV；=0.041）。此外，病例组的功率谱密度（PDS）也高于对照组（0.47±0.03 对 0.39±0.02 Hz；=0.023）。本研究表明，完全性前置胎盘孕妇在妊娠 32-34 周时子宫 EA 更高，这与因大量阴道出血而导致的早产剖宫产风险增加有关。
完全性前置胎盘产前大量出血会导致母婴死亡率和发病率增加，目前尚无有效的预测方法。本研究显示，在因紧急剖宫产而早产分娩的完全性前置胎盘患者中，在妊娠 32-34 周时通过子宫肌电图（EMG）测量的子宫电活动呈活跃模式。EMG 是一种测量子宫电活动的潜在工具，可以指导完全性前置胎盘患者的临床管理，需要进一步的研究来证实其在大样本量中的有效性。
