Kortum Alex, Samuel Christina, Sonka Theresa, Tanner Lisette, Huntley Benjamin J F, Abouseif Ahmed, Oden Z Maria, Schwarz Richard A, Carns Jennifer, Chauhan Suneet P, Bonongwe Phylos, Richards-Kortum Rebecca
Department of Bioengineering, Rice University, Houston, Texas, United States of America.
Rice360 Institute for Global Health Technologies, Houston, Texas, United States of America.
PLoS One. 2025 May 16;20(5):e0323972. doi: 10.1371/journal.pone.0323972. eCollection 2025.
Uterine contraction monitoring during labor has been linked to improved maternal outcomes. However, performing this monitoring can be challenging for financial and logistical reasons in low resource settings. This proof-of-concept study aimed to compare the accuracy of a low cost external tocodynamometer we developed to that of a commercially available external tocodynamometer. In total, 60 patients with anticipated vaginal deliveries at a hospital in Blantyre, Malawi were enrolled. Both the research device and the commercial device were secured to the patients, and traces were recorded simultaneously from each device. Trace pairs were split into 10 minute segments, and contraction locations were independently annotated on a selection of 75 contemporaneous trace pairs from 38 out of 60 patients by two expert clinicians. In total, 484 contractions were marked on the research device, and 465 contractions were marked on the commercially available device, 312 of which were marked consistently on both devices. The average consistency of marked contractions on the same device between the two observers was 0.89 for the research device compared with 0.84 for the commercially available device. The average consistency between the two devices using a 10-patient rolling average increased from 0.50 at the beginning of the study to 0.64 at the end. The annotated traces from the two devices suggested the same clinical management 72% of the time. The research device displayed reasonable agreement with the commercially available tocodynamometer in detecting contractions. The increase in the measured consistency over the course of the study suggests that improving usability of the device to ensure better positioning on the patient could result in improved performance. Further studies assessing the accuracy and usability of the device are needed.
分娩期间的子宫收缩监测与改善产妇结局有关。然而，由于资源匮乏地区的经济和后勤原因，进行这种监测可能具有挑战性。这项概念验证研究旨在比较我们开发的低成本外部宫缩图仪与市售外部宫缩图仪的准确性。总共招募了60名预计在马拉维布兰太尔一家医院进行阴道分娩的患者。研究设备和商业设备都固定在患者身上，并同时记录各自的轨迹。轨迹对被分成10分钟的片段，两名专家临床医生对60名患者中38名患者的75对同期轨迹中的收缩位置进行独立标注。研究设备上总共标记了484次宫缩，市售设备上标记了465次宫缩，其中312次在两个设备上都被一致标记。两名观察者在同一设备上标记宫缩的平均一致性，研究设备为0.89，而市售设备为0.84。使用10名患者滚动平均值时，两个设备之间的平均一致性从研究开始时的0.50增加到结束时的0.64。来自两个设备的标注轨迹在72%的时间里表明了相同的临床管理。研究设备在检测宫缩方面与市售宫缩图仪显示出合理的一致性。研究过程中测量的一致性增加表明，提高设备的可用性以确保在患者身上更好的定位可能会提高性能。需要进一步研究评估该设备的准确性和可用性。
