Authors:
Alba Diaz-Martinez
1
;
Yiyao Ye-Lin
1
;
Rogelio Monfort-Ortiz
2
;
Javier Garcia-Casado
1
;
Iria Rey-Ferreira
2
;
Felix Nieto-del-Amor
1
;
Vicente Diago-Almela
2
;
Jose Martinez-de-Juan
1
and
Gema Prats-Boluda
1
Affiliations:
1
Centro de Investigación e Innovación en Bioingeniería, Universitat Politècnica de València, Valencia 46022, Spain
;
2
Servicio de Obstetricia, H.U.P. La Fe, Valencia 46026, Spain
Keyword(s):
Electrohysterography, Induction of Labour, Foley, Dinoprostone, EHG-Biomarker.
Abstract:
Induction of labour (IOL) refers to triggering the contractions onset, either by pharmacological (PIOL) or mechanical methods (MIOL), and is indicated when maternal and foetal well-being is compromised. There is great uncertainty regarding the success of IOL regardless of the method. In current clinical practice, it is based on assessment of cervical status by Bishop’s score and degree of uterine activity by tocography. However, Bishop’s score has been shown to be subjective and poorly reproducible and tocography requires constant repositioning and is severely affected by obesity. Meanwhile, electrohysterography (EHG) has surpassed traditional clinical measures in monitoring PIOL progress and predicting its outcome. Although there is no evidence of uterine myoelectric activity response of MIOL. Therefore, this work aimed to identify EHG-biomarkers to help to determine possible differences in myoelectric response between PIOL and MIOL success. For this purpose, the uterine response du
ring the first 5h after Dinoprostone (PIOL) administration and Foley catheter (MIOL) insertion was compared by EHG. For PIOL, a significantly lower time to achieve active phase of labor and delivery, together with faster myoelectric response was found: slightly higher contraction force, significantly higher Mean Frequency and lower Spectral Entropy after 2.5h. Between-group differences were especially marked in Spectral Entropy (90-150 and 210-300min). Overall, this pioneering work has demonstrated the feasibility of EHG for the characterisation of evolution also in MIOL. Furthermore, the results suggest that EHG biomarkers may be useful in the IOL method comparison, although they should be cross-checked with expanded databases and further investigations.
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