Robust Characterization of the Uterine Myoelectrical Activity in Different Obstetric Scenarios.

Javier Mas-Cabo,Alba Roca-Prats,Alfredo Perales-Marin,Alba Díaz-Martinez,Rogelio Monfort-Ortiz,Gema Prats-Boluda,Yiyao Ye-Lin,Ángel López-Corral,Javier Garcia-Casado

doi:10.3390/e22070743

Abstract

Electrohysterography (EHG) has been shown to provide relevant information on uterine activity and could be used for predicting preterm labor and identifying other maternal fetal risks. The extraction of high-quality robust features is a key factor in achieving satisfactory prediction systems from EHG. Temporal, spectral, and non-linear EHG parameters have been computed to characterize EHG signals, sometimes obtaining controversial results, especially for non-linear parameters. The goal of this work was to assess the performance of EHG parameters in identifying those robust enough for uterine electrophysiological characterization. EHG signals were picked up in different obstetric scenarios: antepartum, including women who delivered on term, labor, and post-partum. The results revealed that the 10th and 90th percentiles, for parameters with falling and rising trends as labor approaches, respectively, differentiate between these obstetric scenarios better than median analysis window values. Root-mean-square amplitude, spectral decile 3, and spectral moment ratio showed consistent tendencies for the different obstetric scenarios as well as non-linear parameters: Lempel–Ziv, sample entropy, spectral entropy, and SD1/SD2 when computed in the fast wave high bandwidth. These findings would make it possible to extract high quality and robust EHG features to improve computer-aided assessment tools for pregnancy, labor, and postpartum progress and identify maternal fetal risks.

Highlights

There are as yet no reliable tools available for obstetric services to assist clinical staff in making the right decisions regarding the management and planning of the final phase of pregnancy and labor
We found that time reversibility showed a reverse trend without a significant difference between term and preterm deliveries in the TPEHGDB, which agrees with other authors who found that this parameter was not reliable for discriminating term and preterm deliveries [34]
EHG uterine activity in EHG recordings obtained from different protocols in a variety of obstetric scenarios

Summary

Introduction

There are as yet no reliable tools available for obstetric services to assist clinical staff in making the right decisions regarding the management and planning of the final phase of pregnancy and labor This is of special relevance in habitual maternal fetal risk scenarios, such as preterm delivery or postpartum hemorrhage. Diagnosis is the key for preterm birth prevention so as to be able to administer agents that inhibit uterine contractile activity, and when necessary, those that stimulate fetal maturation. Markers such as cervical length or fetal fibronectin have shown some utility in predicting preterm birth.

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