Abstract
Contractions of the non-pregnant uterus play a key role in fertility. Yet, the electrophysiology underlying these contractions is poorly understood. In this paper, we investigate the presence of uterine electrical activity and characterize its propagation in unstimulated ex vivo human uteri. Multichannel electrohysterographic measurements were performed in five freshly resected human uteri starting immediately after hysterectomy. Using an electrode grid externally and an electrode array internally, measurements were performed up to 24 h after hysterectomy and compared with control. Up to 2 h after hysterectomy, we measured biopotentials in all included uteri. The median root mean squared (RMS) values of the external measurements ranged between 3.95 μV (interquartile range (IQR) 2.41–14.18 μV) and 39.4 μV (interquartile range (IQR) 10.84–105.64 μV) and were all significantly higher than control (median RMS of 1.69 μV, IQR 1.13–3.11 μV), consisting of chicken breast meat. The RMS values decreased significantly over time. After 24 h, the median RMS (1.27 μV, IQR 0.86–3.04 μV) was comparable with the control (1.69 μV, IQR 1.13–3.11 μV, p = 0.125). The internal measurements showed a comparable pattern over time, but overall lower amplitude. The measured biopotentials propagated over the uterine surface, following both a plane-wave as well as an erratic pattern. No clear pacemaker location nor a preferred propagation direction could be identified. These results show that ex vivo uteri can spontaneously generate propagating biopotentials and provide novel insight contributing to improving our understanding of the electrophysiology of the human non-pregnant uterus.
Highlights
Similar to other smooth muscle organs, the uterus is able to spontaneously contract
A thorough characterization of the generation and propagation of biopotentials in the non-pregnant uterus may be crucial to advance the basic knowledge of uterine peristalsis and possibly unveil the great potential of contraction management for improving fertility
To the best of our knowledge, this is the first study investigating the propagation of the biopotentials in ex vivo, nonpregnant human uteri
Summary
Significant advances have been reported on the characterization of uterine electrical activity in pregnant uteri by abdominal electrohysterography (EHG) [26, 27, 29, 38, 48, 51] All these studies, aiming at improving labour monitoring and preterm delivery prediction, report patterns of cyclic bursts of biopotentials alternating, in time, with quiescent periods [37, 47]. In vivo characterization of the biopotentials of the non-pregnant human uterus by EHG is severely hampered by challenges related, for example, to the small size of the uterus, the distance between the external electrodes and the uterus, and the interference of other organs These anatomical constraints contribute to a deterioration of the signal-to-noise ratio, complicating the propagation analysis of such unpredictable signals as uterine biopotentials. Since a significant decay of the measured biopotentials can be expected as a consequence of progressive tissue deterioration, the RMS values were evaluated over a time span of 24 h, starting immediately after hysterectomy
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