Automated electrohysterographic detection of uterine contractions for monitoring of pregnancy: feasibility and prospects

• Published in: BMC Pregnancy and Childbirth
• Main Authors: C. Muszynski, T. Happillon, K. Azudin, J.-B. Tylcz, D. Istrate, C. Marque
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2018
• Subjects: Electrohysterogram; Automated contraction detection; Uterine contraction; Premature delivery; Gynecology and obstetrics; RG1-991; Iceland
• Online Access: https://doi.org/10.1186/s12884-018-1778-1; https://doaj.org/article/2e2e109d6a8d47be9be8779779f16ef7

Abstract Background Preterm birth is a major public health problem in developed countries. In this context, we have conducted research into outpatient monitoring of uterine electrical activity in women at risk of preterm delivery. The objective of this preliminary study was to perform automated detection of uterine contractions (without human intervention or tocographic signal, TOCO) by processing the EHG recorded on the abdomen of pregnant women. The feasibility and accuracy of uterine contraction detection based on EHG processing were tested and compared to expert decision using external tocodynamometry (TOCO) . Methods The study protocol was approved by local Ethics Committees under numbers ID-RCB 2016-A00663-48 for France and VSN 02-0006-V2 for Iceland. Two populations of women were included (threatened preterm birth and labour) in order to test our system of recognition of the various types of uterine contractions. EHG signal acquisition was performed according to a standardized protocol to ensure optimal reproducibility of EHG recordings. A system of 18 Ag/AgCl surface electrodes was used by placing 16 recording electrodes between the woman’s pubis and umbilicus according to a 4 × 4 matrix. TOCO was recorded simultaneously with EHG recording. EHG signals were analysed in real-time by calculation of the nonlinear correlation coefficient H2. A curve representing the number of correlated pairs of signals according to the value of H2 calculated between bipolar signals was then plotted. High values of H2 indicated the presence of an event that may correspond to a contraction. Two tests were performed after detection of an event (fusion and elimination of certain events) in order to increase the contraction detection rate. Results The EHG database contained 51 recordings from pregnant women, with a total of 501 contractions previously labelled by analysis of the corresponding tocographic recording. The percentage recognitions obtained by application of the method based on coefficient H2 was 100% with 782% of ...