Intensity Of Uterine Contractions Research Articles

Comparison between using an Automatic Uterine Massage Machine and manual uterine massage on postpartum blood loss within two hours after delivery at labour room, Phramongkutklao Hospital

This experimental study compares the effectiveness of Automatic Uterine Massage Machine (AUMM) and Manual Uterine Massage on uterine contraction intensity and the amount of postpartum blood loss within two hours after delivery. The participants consisted of 60 postpartum women who were within 2 hours of their normal delivery at Phramongkutklao Hospital, Bangkok, Thailand. The experimental and comparison groups each consisted of 30 participants allocated by a simple random method when visiting the labour room. The comparison group received a manual uterine massage by a nurse, while the experimental group received AUMM. Both groups received standard postpartum care, which included assessment for postpartum hemorrhage, administration of oxytocin 10 units, and ensuring an empty bladder. Mann-Whitney U test was used to analyze the difference in uterine contraction intensity and amount of postpartum blood loss between the groups. The participants’ characteristics between the groups revealed no statistically significant differences (p > 0.05). The manual uterine massage group exhibited significantly stronger uterine contractions compared to the AUMM group (p < 0.001). The key findings indicated that there was no significant difference in the amount of blood loss during the first 2 hours after delivery between the two groups (p = 0.323). Although using AUMM resulted in a significantly lower uterine contraction intensity, the amount of postpartum blood loss was not significantly different compared to the manual uterine massage group. Therefore, AUMM could be an alternative to manual uterine massage, especially in healthcare facilities facing a shortage of nursing staff, particularly during the critical period of the first 2 hours after delivery.

An EHG-based Preterm Delivery Prediction Algorithm via Convolution Neural Network

Premature delivery is one of the direct factors that affect the early development and safety of infants. Its direct clinical manifestation is the change of uterine contraction intensity and frequency. Uterine Electrohysterography(EHG) signal collected from the abdomen of pregnant women can accurately and effectively reflect the uterine contraction, which has higher clinical application value than invasive monitoring technology such as intrauterine pressure catheter. Therefore, the research of fetal preterm birth recognition algorithm based on EHG is particularly important for perinatal fetal monitoring. We proposed a convolution neural network(CNN) based on EHG fetal preterm birth recognition algorithm, and a deep CNN model was constructed by combining the Gramian angular difference field(GADF) with the transfer learning technology. The structure of the model was optimized using the clinical measured term-preterm EHG database. The classification accuracy of 94.38% and F1 value of 97.11% were achieved. The experimental results showed that the model constructed in this paper has a certain auxiliary diagnostic value for clinical prediction of premature delivery.

Experimental substantiation of novocaine therapy for threatened abortion

Published in 1955 by R.A.Vortapetov and P.G.Zhuchenko data on the favorable result of treatment with novocaine in 80 women with threatening termination of pregnancy prompted us to experimentally study the nature of the effect of novocaine introduced into the vascular bed on the intensity of uterine contractions

PENGARUH TEKNIK EFFLEURAGE MASSAGE TERHADAP NYERI AFTERPAINS PADA IBU NIFASMULTIPARA DI BPM WANTI DAN BPM SARTIKA DI KOTA MEDAN TAHUN 2020

Post-partum mothers often experience changes both physiologically and psychologically, one of which is a change in the body's reaction due to uterine contractions. The intensity of uterine contractions increases after delivery which causes pain and makes the mother uncomfortable. Many experienced pain disorders during the puerperium even in uncomplicated normal delivery. This causes discomfort in the mother, especially in the abdominal area due to uterine contractions called afterpains. This massage therapy can minimize and even suppress pain with minimal side effects or even no side effects, one of which is using effleurage massage techniques. This study aimed to determine the effect of effleurage massage technique on afterpains pain in multiparous postpartum mothers. This research is a quasi experiment or quasi-experiment. The design of this study used a one group pre-test-post-test design. The results showed that the pain intensity in postpartum mothers before the effleurage massage technique experienced moderate pain, namely 73.3%, and mild pain, namely 26.7%, after effleurage massage 83.3% experienced mild pain and did not experience pain, namely 16 7%. The results of this study concluded that the effleurage massage technique can be used as a non-pharmacological therapy that can overcome the afterpains pain in postpartum mothers, thereby reducing the pain felt by the mother and will make the mother feel comfortable.

Effects of acupuncture on labor pain in primipara mothers

Pain is usually regarded as a pathological phenomenon, and during labor, prolonged intense pain can negatively impact both the mother and baby. Acupuncture is a potential pain relief method suitable during childbirth. This study aimed to evaluate the effects of acupuncture therapy on reducing pain during normal labor in primipara mothers. A randomized, single-blind, clinical trial was performed on 50 pregnant women. Twenty-five women were assigned to the acupuncture treatment group and 25 women to the control group. All women received the same care related to labor and delivery. The treatment group received acupuncture therapy at the time of phase I labor or when pain started to interrupt, whereas the control group did not. The numeric analog scale (NAS) score, amount of labor pain, duration and intensity of uterine contractions, and duration of phase II of delivery were calculated for each woman. After delivery, APGAR scores were recorded for the babies. Acupuncture significantly reduced pain associated with labor (p < 0.05). Acupuncture therapy is effective for reducing labor pain, strengthening uterine contractions, and speeding up phase II of delivery. Acupuncture had no side effects on mothers or babies.

Mechanism Identification of Ficus Deltoidea Aqueous Extract in Rat Uterine Contractions

Ficus deltoidea or ‘mas cotek,’ is a uterotonic herb traditionally consumed by women to improve menstrual circulation, assist labour, remove retained placenta and treat postpartum bleeding. The aim of the study was to elucidate the mechanism of F. deltoidea in uterine contraction. Crude extracts from 2 different variants of F. deltoidea were used in the study; F. deltoidea var. Deltoidea (FDD) and F. deltoidea var. Angustifolia (FDA). This study was conducted ex vivo on the strips of isolated rats uterus treated with either FDD or FDA aqueous extract with increasing concentrations ranging from 10 μg/ml until 1280 μg/ml at time intervals of 5 minutes between doses. The frequency and intensity of the uterine contractions were monitored via Powerlab software. Maximum contractions for both extracts were identified, recorded and the uterine strips samples at maximum contraction were selected and homogenized in order determine the role of prostaglandin F2α (PGF2α) in the mechanism of uterine contraction. Other than that, phosphorylated 42/44 (p42/44) of mitogen activated protein kinase (MAPK) expression was also detected via immunoblotting. The results showed that the maximum contraction induced by FDD was at the concentration of 320 μg/ml, whereas for FDA was at 960 μg/ml. Both FDD and FDA increased the intensity of uterine strips contractions and there were notable trend of increased PGF2α expression as well. Further analysis revealed that the uterine contractions involved the MAPK pathway through the phosphorylation of p42/44 protein. In conclusion, Ficus deltoidea of both variants have the ability to stimulate uterine contraction through the mechanism of MAPK pathway. DOI : http://dx.doi.org./10.17576/JSKM-2018-11

Uterine contractility and elastography as prognostic factors for pregnancy after intrauterine insemination

To determine the impact of the frequency and intensity of uterine contractions (UCs) at the time of IUI on subsequent fertility. Observational pilot study. University hospital. One hundred volunteer women scheduled for IUI between April 2011 and July 2013, in whom UCs were assessed during the ultrasound before IUI. A two-dimensional sagittal uterus elastography was recorded for 5minutes. The elasticity index, defined as the mean ratio of elastographic measurements between the subendometrial area (of interest) and the endometrial area (control), was computed. UC frequency, endometrial thickness and volume, and subendometrial vascularisztion were also measured. These parameters, along with characteristics of the IUI cycle, were entered into a logistic regression model for predicting ongoing pregnancy. The elasticity index was significantly higher (2.4 ± 1.3 vs. 1.5 ± 0.7, i.e., with stiffer myometrium), and the endometrium was significantly less echogenic in future pregnant women. Factors closely reaching significance were age, previous fertility, day 3 hormonal assessments, number of inseminated spermatozoa, endometrial thickness, and UC count. In multivariate analysis, low UC frequency (<2.8/minute; odds ratio [OR] = 0.039), high elasticity index (>1.7; OR = 63.26), high endometrial thickness on the ovulation triggering day (>8mm; OR = 28.21), and low patient age (<32years; OR = 0.001) were predictive of pregnancy after IUI. A low frequency and high intensity of UCs at the day of IUI appears associated with a higher pregnancy rate. Elastography provides a promising innovative tool for IUI monitoring.

Intrapartum transperineal ultrasound for evaluating uterine contraction intensity in the second stage of labor.

To clarify whether intrapartum transperineal ultrasound (ITU) can be used to evaluate uterine contraction intensity, and whether the intensity is associated with the duration of the second stage. A prospective observational study was performed involving 86 women with a normal singleton term fetus and more than three contractions every 10min. ITU was performed for contractile and non-contractile periods of labor at the beginning of the second stage, and one representative "angle of progression (AoP)" image was selected for each period. The Mann-Whitney U test was used to compare ∆AoP, the difference between the two angles, depending on the duration of the second stage. Receiver operating characteristic curves were used to evaluate the probability of duration of the second stage≤50min in nulliparous women. Among nulliparous women, ΔAoP differed significantly according to the duration of the second stage (52.5°±5.0° for≤50min vs. 30.9°±2.1° for >50min; P<0.001). Receiver operating characteristic curve analysis showed that approximately 85% of nulliparous women with ΔAoP greater than 40° delivered within 50min. These findings could be utilized in the evaluation of uterine contraction intensity, and ∆AoP measurement could be used to predict the duration of the second stage of labor in nulliparous women.

What is normal progress in the first stage of labour? A vignette study of similarities and differences between midwives and obstetricians

Objectiveintrapartum referrals are high-risk situations. To ensure patient safety, care professionals need to have a shared understanding of a labouring woman's situation. We aimed to gain insight into similarities and differences between midwives and obstetricians in the assessment of a prolonged first stage of labour and the decision to refer a woman to a clinical setting in the Netherlands. Designfactorial survey. Settingin the Netherlands, the main caregivers for women with low risks of pathology are primary-care midwives working in the locality. Approximately half of all women start labour under supervision of primary-care midwives. Roughly 40% of these women are referred to a hospital during labour, where obstetricians take over responsibility. In 2013, the reason for referral for 5161 women (14.1% of all referrals during labour) was a prolonged first stage of labour. Participantsrespondents consisted of primary-care midwives (N=69), obstetricians (N=47) and hospital based midwives, known as clinical midwives (N=31). Measurementseach respondent assessed seven hypothetical vignettes. The assessment of a prolonged first stage of labour and the decision to refer a woman to a clinical setting based on this indication were used as outcome measures, rated on a 7-point Likert scale (1=very unlikely to 7=very likely). Data were analysed using a linear multilevel model with a two-level hierarchy. Findingscompared to primary-care midwives, obstetricians were more likely to define a prolonged first stage of labour when progress in cervical dilation was slow (b: 1.11; 95% CI: 0.66 – 1.57). The attributes parity, progress, intensity of uterine contractions and the woman's state of mind, were used by all three groups in the decision to refer a woman to clinical setting based on a prolonged first stage of labour. Key conclusion and implications for practicewe found relevant interprofessional differences and similarities in the assessment of a prolonged first stage of labour and consequent referral. Further interprofessional alignment of clinical assessments, for instance through interprofessional discussions and a review of professional guidelines, might help to improve collaborative care.

Eficacia del misoprostol vía sublingual comparado con vía oral en el tercer periodo del parto

OBJETIVO: Determinar si el misoprostol administrado por vía sublingual es más eficaz que administrado vía oral en el tercer período del parto. DISEÑO: Se realizó un estudio experimental. Prospectivo, de corte transversal, comparativo (dos grupos pareados). LUGAR: Servicio de Obstetricia del Hospital Regional Docente de Trujillo, durante los meses de junio a diciembre de 1991. MATERIAL: La muestra estuvo conformada por 2 grupos de 39 gestantes cada uno, elegidas en forma secuencial, en el que uno de ellos recibió 200 μg de misoprostol vía sublingual (triturado) y el otro vía oral. Los indicadores para evaluar la eficacia del misoprostol fueron el tiempo de alumbramiento, el volumen de sangrado y la intensidad de las contracciones uterinas, así como sus efectos colaterales. RESULTADOS: Para las vías sublingual y oral, en promedio, los tiempos de alumbramiento fueron 5.1 y 10.6 minutos, de sangrado uterino de 170,4 y 266.9 ml y la intensidad de la contracción de 2,87 (+) y 1,28 (+), respectivamente, siendo el valor de p&lt;0,001. Los efectos colaterales más frecuentes se presentaron con el misoprostol vía sublingual y fueron fiebre y escalofríos, siendo estos transitorios. CONCLUSIÓN: El misoprostol administrado por vía sublingual es más eficaz que administrado vía oral en el tercer período del parto de manera altamente significativa. Disminuye el tiempo de alumbramiento y el volumen de sangrado, así como produce una contracción uterina más intensa.

Factors affecting uterine electrical activity during the active phase of labor prior to rupture of membranes

Objective: Limited data exist regarding uterine contraction intensity prior to membrane rupture. Using a novel technique of electrical uterine myography (EUM) we aimed to determine which factors affect myometrial activity during active phase of labor.Methods: EUM was prospectively measured in 37 women with singleton pregnancy at term during the active phase of labor until membranes’ rupture. EUM was measured using non-invasive nine channels recorder with an EMG amplifier and three-dimensional position sensor. Uterine electrical activity was quantified with the EUM-index, defined as the mean electrical activity of the uterine muscle over a period of 10 min and measured in units of micro-Joule (microwatt per second [mW/s]).Results: The mean EUM-index at the first 10 min of the measurement was 3.3 ± 0.6 mW/s. In a stepwise linear regression model accounting potential confounders EUM was significantly affected by cervical dilatation (p = 0.005), maternal age (p = 0.04) and previous cesarean delivery status (p = 0.02). In a repeated measurement assessment of non-parametric Fridman’s test for all subjects who had at least 10 continuouss EUM measurements, there was a significant increase in electrical uterine activity as labor progressed (p = 0.01).Conclusion: Electrical uterine activity during the active phase of labor prior to rupture of membranes is affected by maternal age, previous cesarean delivery status and cervical dilatation. Moreover, electrical uterine activity is enhanced throughout labor.

Gynipral use for correction hypertonic dysfunction of uterus activity

There are various forms of hypertonic dysfunction of uterus activity. Untreated hypertensive dysfunction uterus activity due to the presence of pathological preliminaries prenatal period incoordinate uterine anomaly pass in abnormal delivery. At delivery segmental dystocia can pass in total. For the treatment of hypertension dysfunction of uterine used the infusion of β-agonists, calcium antagonists, antispasmodics, analgesics. Epidural anesthesia starts after disclosure of cervix to 4 cm. β-agonists using reduces the tone and contractile activity of the myometrium, reduces the frequency and intensity of uterine contractions, and normalizes excessively heavy or irregular contractions. The most effective and safest sympathomimetic is β-agonists Gynipral.

PRETERM LABOUR

Objective: To compare the efficacy of Glyecryl trinitrate patch for prolonging gestation for more than 48 hours, 7 days or upto 37 weeks of gestation with Salbutamol in preterm labour. Study Design: Compartive descriptive study. Setting: Fatima Memorial HospitalLahore. Period: Dec 2003 to Jan 2005. Patients &amp; Methods: The study was carried out on 60 pregnant patients admitted in hospital with thesymptoms and signs of preterm labour. The results were statistically analyzed using SPSS version 8.0. Results: Two groups (TransdermalGlyceryl Trinitrate group and Salbutamol) comprising 30 patients each were made. In Glyceryl Trinitrate group, transdermal patch was appliedand in Salbutamol group,. Intravenous infusion titrated according to frequency, duration and intensity of uterine contractions. All the patientsin each group were evaluated for prolongation of gestation for 48 hours till 37th week of gestation. The mean prolongation of pregnancy was26 days in GTN group and 32 days in Salbutamol group. The decrease in frequency of uterine contractions by 67.51 ± 7.74% in first 48 hoursof applying transdermal Glyceryl Trinitrate patch and by 80.14 ± 8.43 % in Salbutamol group which was statistically significant. Conclusion:Trinitrate appears to be a safe, well tolerated and non-invasive but less effectives method of suppressing uterine contraction in preterm labouras compared to Salbutamol.

Uterine artery flow velocity waveforms during uterine contractions: Differences between oxytocin‐induced contractions and spontaneous labor contractions

To clarify the effects on uterine arterial flow velocity waveforms of uterine contractions following oxytocin infusion and during spontaneous labor. Uterine arterial flow velocity waveforms were obtained by pulsed Doppler methods from 22 women during an oxytocin challenge test (OCT), 26 women during oxytocin-induced labor, and 40 women during spontaneous labor. Mean resistance index (RI) for bilateral arteries was used for analyses. After the onset of labor, flow velocity waveforms were assessed according to cervical dilatation. During OCT, Doppler flow velocimetry was performed when three uterine contractions occurred per 10-min period. RI values did not differ significantly between induced and spontaneous labor during relaxations at any level of cervical dilatation. However, during contractions, RI was significantly higher for induced labor than for spontaneous labor. Absence or reversal of flow was more frequent in the OCT group than in the induced labor group (P < 0.0001). However, no significant differences were found between spontaneous and induced labor groups. Interactions between the contracting uterine body and the relaxing lower segment in oxytocin-induced labor might be associated with differences in uterine arterial flow during contraction between oxytocin-induced and spontaneous labor. However, changes in the intensity of uterine contractions during labor progression might differ between oxytocin-induced and spontaneous labor.

Influence of time at which oxytocin is administered during labor on uterine activity and perinatal death in pigs

Oxytocin is extensively used to induce or augment uterine contractions, especially to facilitate the third stage of labor in humans. Administration of oxytocin to parturient sows reduces duration of labor whereas mortality of the offspring may remain unchanged. This study aimed to evaluate whether time of administration of oxytocin during parturition may alter the uterine response and fetal outcomes. Two hundred parturient sows were randomly assigned to intramuscularly receive either saline solution (control group) or oxytocin 0.083 IU/kg immediately after the delivery of the 1st, 4th or 8th piglet (groups O-1, 0-4 and 0-8, respectively). Uterine effects and fetal outcomes were registered in all groups. The duration of labor was 20-40 min shorter (P < 0.0001) and time interval between babies was reduced by 3-5 min (P < 0.0001) in the three groups receiving oxytocin. The duration and intensity of contractions, meconium-stained piglets and intrapartum deaths decreased as time at which oxytocin administered during labor was increased. In group 0-8, we observed approximately 70% less meconium-stained piglets and intrapartum deaths than in the control group. In conclusion, oxytocin administered at early phases of parturition to sows may increase duration and intensity of uterine contractions as well as adverse fetal outcomes.

Dose minimization study of oxytocin in early labor in sows: Uterine activity and fetal outcome

Two hundred sows were randomly assigned to intramuscularly receive 0.9% NaCl (group 1) or oxytocin 0.083, 0.11 or 0.17 IU/kg (groups 2, 3 and 4, respectively) immediately after the expulsion of the first piglet. The overall duration of labor was decreased in a dose-dependent relationship. Time interval between piglets was decreased approximately 5 min in groups 3 and 4 while sows in these groups exhibited approximately 10–20 contractions × 10 births more than controls ( P < 0.005). Duration and intensity of uterine contractions also showed a positive dose–response relationship. As an indicative of fetal distress, approximately 2.5 times more meconium-stained piglets were born to sows receiving the higher doses of oxytocin, but in the lowest dose significantly decreased. Oxytocin 0.083 IU/kg significant decreased the mortality rate of piglets [OR 0.49 (95%CI, 0.26–0.92)]. In conclusion, we recommend the intramuscular administration of the lowest possible dose of oxytocin, which still decreases the duration of labor in sows.

Sonographic Evaluation of the Puerperal Uterus: Correlation with Manual Examination

Objectives: To document uterine involution after vaginal delivery and cesarean section by abdominal sonography and to compare the efficacy of manual examination and ultrasonography. Study Design: Postpartum manual and sonographic assessment of uterine involution was performed in 120 patients following vaginal and cesarean delivery with an attempt to build a database of changes in uterine dimensions. The patients’ reports on the intensity of uterine contractions and vaginal bleeding were compared to the results of sonographic imaging. Results: Palpation revealed proper uterine involution in 80 and 25% of patients after vaginal delivery and cesarean section, respectively. It could not be performed in 2.5% after vaginal delivery compared to 50% after cesarean section. Uterine length was found to be significantly greater after cesarean section than after vaginal delivery (p = 0.0001), and the anterior uterine wall was significantly thinner than the posterior wall (p = 0.0001). Uterine length was significantly greater in the presence of blood accumulation in the uterine cavity (20.7 cm), than when the uterus was empty (18.8 cm) (p = 0.001). In correlating between the patient’s report of intense bleeding and the sonographic picture of blood in the uterine cavity sonography had a sensitivity of 0.56 and a specificity of 0.83, whereas the patients’ reports had a positive predictive value of 0.22. The difference in information provided by the patients versus that provided by sonography was highly significant (p = 0.001, χ² test). Conclusion: Within 3 days after delivery, patients particularly those having had a cesarean section, should undergo uterine sonographic scanning and manual palpation to evaluate involution and presence of blood in the uterine cavity.

460 The intensity of uterine contractions can be estimated using transabdominal uterine electromyography

460 The intensity of uterine contractions can be estimated using transabdominal uterine electromyography

495 The intensity of uterine contractions in rats during pregnancy and parturition can be estimated from electromyography signals

495 The intensity of uterine contractions in rats during pregnancy and parturition can be estimated from electromyography signals

Thrombin-stimulated uterine contractions in the pregnant and nonpregnant rat

Thrombin generated during the active clotting of blood appears to be a potent uterotonic agonist; however, the mechanism underlying this effect on uterine smooth muscle is not well understood. We performed studies to confirm the uterotonic effects of thrombin and to determine whether prostaglandin production plays a role during the uterotonic effects of thrombin or clotting blood. Uterine contraction studies were performed using adult nonpregnant and near-term pregnant rats. The in vitro isometric contraction studies used uterine strips pretreated with indomethacin or vehicle (ethanol), which were then stimulated with thrombin. For the in vivo contraction studies, rats were pretreated with intraperitoneal injections of indomethacin or vehicle (ethanol) then stimulated by intraluminal injection of fresh rat blood or thrombin into the uterus. The contraction data were acquired using isometric force transducers, were computer digitized, normalized for spontaneous activity, and statistically analyzed. Prostaglandin (PG) F2alpha was measured using an enzyme-linked immunoassay. The in vitro contraction studies demonstrated that both thrombin and actively clotting blood produce a significant increase in the frequency and intensity of uterine contractions. Thrombin stimulation was associated with a 54% increase in PGF2alpha concentration in vitro; indomethacin (1 microM) pretreatment completely inhibited that increase in PGF2alpha production. Despite the suppression of PGF2alpha production, pretreatment with indomethacin had no inhibitory effect on thrombin-stimulated contractile activity. In vivo contraction studies further confirmed that indomethacin (2 mg/kg) pretreatment had no effect on blood- or thrombin-stimulated contractile activity. We confirmed that thrombin and thrombin produced by actively clotting blood had a robust uterotonic effect in the rat and that prostaglandin production did not play a significant role in thrombin-stimulated contractions.