Abstract

Uterine contraction (UC) is an essential clinical indicator in the progress of labour and delivery. Electrohysterogram (EHG) signals recorded on the abdomen of pregnant women reflect the uterine electrical activity. This study proposes a novel algorithm for automatic recognition of UCs with EHG signals to improve the accuracy of detecting UCs. EHG signals by electrodes, the tension of the abdominal wall by tocodynamometry (TOCO) and maternal perception were recorded simultaneously in 54 pregnant women. The zero-crossing rate (ZCR) of the EHG signal and its power were calculated to modulate the raw EHG signal and highlight the EHG bursts. Then the envelope was extracted from the modulated EHG for UC recognition. Besides, UC was also detected by the conventional TOCO signal. Taking maternal perception as a reference, the UCs recognized by EHG and TOCO were evaluated with the sensitivity, positive predictive value (PPV), and UC parameters. The results show that the sensitivity and PPV are 87.8% and 93.18% for EHG, and 84.04% and 90.89% for TOCO. EHG detected a larger number of UCs than TOCO, which is closer to maternal perception. The duration and frequency of UC obtained from EHG and TOCO were not significantly different (p > 0.05). In conclusion, the proposed UC recognition algorithm has high accuracy and simple calculation which could be used for real-time analysis of EHG signals and long-term monitoring of UCs.

Highlights

  • Uterine contraction (UC) is an essential clinical indicator in the progress of labour and delivery

  • We propose a method for automatic recognition of UCs with EHG signals

  • The number of UCs recognized by EHG is larger than TOCO, which is closer to maternal perception

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Summary

Introduction

Uterine contraction (UC) is an essential clinical indicator in the progress of labour and delivery. Electrohysterogram (EHG) signals recorded on the abdomen of pregnant women reflect the uterine electrical activity. The proposed UC recognition algorithm has high accuracy and simple calculation which could be used for real-time analysis of EHG signals and long-term monitoring of UCs. Uterine contraction (UC) is the result of the electrical activity within the myometrium. EHG is more reliable and similar in accuracy to TOCO in detecting UCs compared to I­UPC11 and is applicable for long-term monitoring uterine activity throughout pregnancy and delivery. It has been reported that the bursts of action potential spikes occurred in both intrauterine and abdominal electrical signals synchronized with the UCs identified by simultaneously recorded intrauterine. EHG burst associated with UC could be detected, and its envelope of slow wave is described to replace the routine clinical TOCO for long-term ambulatory uterine monitoring

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