A Comparative Study of Vaginal Labor and Caesarean Section Postpartum Uterine Myoelectrical Activity

Fecha de publicación: 01/06/2020 Fecha Ahead of Print: 26/05/2020

Autores de IIS La Fe

• Isauro Rogelio Monfort Ortiz

  Autor

• Angel Lopez Corral

  Autor

• Maria De Arriba Garcia

  Autor

• Alfredo José Perales Marín

  Autor

Participantes ajenos a IIS La Fe

• Diaz-Martinez, A
• Mas-Cabo, J
• Prats-Boluda, G
• Garcia-Casado, J
• Cardona-Urrego, K
• Ye-Lin, YY

Grupos

• Medicina Reproductiva

  

  Investigador Principal

  José Morales Roselló

Abstract

Postpartum hemorrhage (PPH) is one of the major causes of maternal mortality and morbidity worldwide, with uterine atony being the most common origin. Currently there are no obstetrical techniques available for monitoring postpartum uterine dynamics, as tocodynamometry is not able to detect weak uterine contractions. In this study, we explored the feasibility of monitoring postpartum uterine activity by non-invasive electrohysterography (EHG), which has been proven to outperform tocodynamometry in detecting uterine contractions during pregnancy. A comparison was made of the temporal, spectral, and non-linear parameters of postpartum EHG characteristics of vaginal deliveries and elective cesareans. In the vaginal delivery group, EHG obtained a significantly higher amplitude and lower kurtosis of the Hilbert envelope, and spectral content was shifted toward higher frequencies than in the cesarean group. In the non-linear parameters, higher values were found for the fractal dimension and lower values for Lempel-Ziv, sample entropy and spectral entropy in vaginal deliveries suggesting that the postpartum EHG signal is extremely non-linear but more regular and predictable than in a cesarean. The results obtained indicate that postpartum EHG recording could be a helpful tool for earlier detection of uterine atony and contribute to better management of prophylactic uterotonic treatment for PPH prevention.

Keywords

• electrohysterogram; uterine myoelectrical activity; postpartum hemorrhage; signal characterization; uterotonic therapy