Department of Obstetrics, University Hospital Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland.
Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland.
Arch Gynecol Obstet. 2023 Nov;308(5):1447-1456. doi: 10.1007/s00404-022-06753-4. Epub 2022 Sep 13.
To evaluate the use of wearable sensors for prediction of intraamniotic infection in pregnant women with PPROM.
In a prospective proof of principle study, we included 50 patients diagnosed with PPROM at the University Hospital Zurich between November 2017 and May 2020. Patients were instructed to wear a bracelet during the night, which measures physiological parameters including wrist skin temperature, heart rate, heart rate variability, and breathing rate. A two-way repeated measures ANOVA was performed to evaluate the difference over time of both the wearable device measured parameters and standard clinical monitoring values, such as body temperature, pulse, leucocytes, and C-reactive protein, between women with and without intraamniotic infection.
Altogether, 23 patients (46%) were diagnosed with intraamniotic infection. Regarding the physiological parameters measured with the bracelet, we observed a significant difference in breathing rate (19 vs 16 per min, P < .01) and heart rate (72 vs 67 beats per min, P = .03) in women with intraamniotic infection compared to those without during the 3 days prior to birth. In parallel to these changes standard clinical monitoring values were significantly different in the intraamniotic infection group compared to women without infection in the 3 days preceding birth.
Our results suggest that wearable sensors are a promising, noninvasive, patient friendly approach to support the early detection of intraamniotic infection in women with PPROM. However, confirmation of our findings in larger studies is required before implementing this technique in standard clinical management.
评估可穿戴传感器在预测胎膜早破孕妇羊膜腔内感染中的应用。
在一项前瞻性原理验证研究中,我们纳入了 2017 年 11 月至 2020 年 5 月期间在苏黎世大学医院诊断为胎膜早破的 50 例患者。患者被指示在夜间佩戴手镯,该手镯可测量包括腕部皮肤温度、心率、心率变异性和呼吸频率在内的生理参数。采用双向重复测量方差分析评估有和无羊膜腔内感染的女性之间,可穿戴设备测量的参数和标准临床监测值(如体温、脉搏、白细胞和 C 反应蛋白)随时间的差异。
共有 23 例(46%)患者被诊断为羊膜腔内感染。关于手镯测量的生理参数,我们观察到在分娩前 3 天,感染组的呼吸频率(19 次/分钟与 16 次/分钟,P<.01)和心率(72 次/分钟与 67 次/分钟,P=.03)有显著差异。与这些变化平行的是,在感染组中,与无感染的女性相比,在分娩前 3 天标准临床监测值也有显著差异。
我们的结果表明,可穿戴传感器是一种有前途的、非侵入性的、患者友好的方法,可以支持胎膜早破孕妇羊膜腔内感染的早期检测。然而,在将该技术纳入标准临床管理之前,需要在更大的研究中证实我们的发现。