Department of Obstetrics and Gynaecology, Kutahya Health Sciences University, 43000, Kutahya, Turkey.
Department of Statistics, Faculty of Arts and Science, Middle East Technical University, 06800, Ankara, Turkey.
Reprod Sci. 2021 Jul;28(7):1989-1995. doi: 10.1007/s43032-020-00435-9. Epub 2021 Jan 13.
We investigate motion mode (M-mode) ultrasound scan as a potential non-invasive uterine monitoring technique and compare its contraction characteristics with external tocodynamometry (TOCO). This prospective diagnostic accuracy study included 39 term pregnant woman in active spontaneous labor. M-mode and TOCO were simultaneously performed and uterine contraction characteristics and consistency were compared quantitatively and visually. The results identified a 71.5% ± 35.3% uterine wall thickening during uterine contractions on M-mode. Uterine monitoring with M-mode had a consistency rate of 88.7% ± 6.9% with conventional TOCO method. During 20-min monitoring, the number of detected contractions was significantly higher (p < 0.001) in M-mode (8.2 ± 1.2) than TOCO (7.4 ± 1.5). As for the mean value of the duration of a contraction (seconds), it was significantly shorter (p < 0.001) in M-mode (38.5 ± 3.5) than TOCO (49.2 ± 4.1). For M-mode, the number of detected contractions had a negative but insignificant correlation with the body mass index (BMI) (r = - 0.25 [- 0.52, 0.07], p = 0.127) and the subcutaneous tissue thickness (STT) (r = - 0.21 [- 0.49, 0.11], p = 0.200). As for TOCO, the contractions had a negative and significant correlation with BMI (r = - 0.41 [- 0.64, - 0.11], p = 0.009) and negative and insignificant correlation with STT (r = - 0.26 [- 0.54, 0.06], p = 0.104). The evidence suggests that contraction detection with M-mode is a promising non-invasive technique for uterine monitoring. The preliminary analysis finds that contraction detection is not affected by BMI or STT. With future sensitivity studies, and improvements in image-processing and software technologies, the proposed technique promises to be a viable alternative to existing techniques, especially for obese patients.
我们研究了运动模式（M 模式）超声扫描作为一种潜在的非侵入性子宫监测技术，并将其与外部胎儿监护仪（TOCO）的收缩特征进行了比较。这项前瞻性诊断准确性研究纳入了 39 名处于活跃自发性分娩的足月孕妇。同时进行 M 模式和 TOCO 检查，定量和直观比较子宫收缩特征和一致性。结果显示，在 M 模式下，子宫收缩时子宫壁增厚 71.5%±35.3%。M 模式下的子宫监测与传统的 TOCO 方法的一致性率为 88.7%±6.9%。在 20 分钟的监测过程中，M 模式下检测到的收缩次数明显高于 TOCO 方法（8.2±1.2 比 7.4±1.5，p<0.001）。至于收缩持续时间的平均值（秒），M 模式明显更短（p<0.001）（38.5±3.5 比 49.2±4.1）。对于 M 模式，检测到的收缩次数与体重指数（BMI）（r=-0.25[-0.52,0.07]，p=0.127）和皮下组织厚度（STT）（r=-0.21[-0.49,0.11]，p=0.200）呈负相关，但无统计学意义。对于 TOCO，收缩与 BMI 呈负相关且有统计学意义（r=-0.41[-0.64,-0.11]，p=0.009），与 STT 呈负相关但无统计学意义（r=-0.26[-0.54,0.06]，p=0.104）。证据表明，M 模式下的收缩检测是一种很有前途的子宫监测非侵入性技术。初步分析发现，收缩检测不受 BMI 或 STT 的影响。随着未来敏感性研究的开展，以及图像处理和软件技术的改进，该技术有望成为现有技术的可行替代方案，特别是对于肥胖患者。
