Journal of perinatology : official journal of the California Perinatal Association · 2018
Could electrohysterography be the solution for external uterine monitoring in obese women?
Сравнительное исследованиеСтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Vlemminx Marion W C, Thijssen Kirsten M J, Bajlekov Galin I, Dieleman Jeanne P, Van Der Hout-Van Der Jagt M Beatrijs, Oei S Guid
Аннотация
OBJECTIVE: To evaluate the influence of maternal obesity on the performance of external tocodynamometry and electrohysterography.
STUDY DESIGN: In a 2-hour measurement during term labor, uterine contractions were simultaneously measured by electrohysterography, external tocodynamometry, and intra-uterine pressure catheter. The sensitivity was compared between groups based on obesity (non-obese/obese/morbidly obese) or uterine palpation (good/moderate/poor), and was correlated to maternal BMI and abdominal circumference.
RESULT: We included 14 morbidly obese, 18 obese, and 20 non-obese women. In morbidly obese women, the median sensitivity was 87.2% (IQR 74-93) by electrohysterography and 45.0% (IQR 36-66) by external tocodynamometry (p < 0.001). The sensitivity of electrohysterography appeared to be non-influenced by obesity category (p = 0.279) and uterine palpation (p = 0.451), while the sensitivity of tocodynamometry decreased significantly (p = 0.005 and p < 0.001, respectively). Furthermore, the sensitivity of both external methods was negatively correlated with obesity parameters, being non-significant for electrohysterography (range p-values 0.057-0.088) and significant for external tocodynamometry (all p-values < 0.001).
CONCLUSIONS: Electrohysterography performs significantly better than external tocodynamometry in case of maternal obesity.
STUDY DESIGN: In a 2-hour measurement during term labor, uterine contractions were simultaneously measured by electrohysterography, external tocodynamometry, and intra-uterine pressure catheter. The sensitivity was compared between groups based on obesity (non-obese/obese/morbidly obese) or uterine palpation (good/moderate/poor), and was correlated to maternal BMI and abdominal circumference.
RESULT: We included 14 morbidly obese, 18 obese, and 20 non-obese women. In morbidly obese women, the median sensitivity was 87.2% (IQR 74-93) by electrohysterography and 45.0% (IQR 36-66) by external tocodynamometry (p < 0.001). The sensitivity of electrohysterography appeared to be non-influenced by obesity category (p = 0.279) and uterine palpation (p = 0.451), while the sensitivity of tocodynamometry decreased significantly (p = 0.005 and p < 0.001, respectively). Furthermore, the sensitivity of both external methods was negatively correlated with obesity parameters, being non-significant for electrohysterography (range p-values 0.057-0.088) and significant for external tocodynamometry (all p-values < 0.001).
CONCLUSIONS: Electrohysterography performs significantly better than external tocodynamometry in case of maternal obesity.