Characterization of Uterine Response to Misoprostol based on Electrohysterogram

C. Benalcazar Parra, R Montfort-Orti, Y. Ye-Lin, J. Alberola-Rubio, A. Perales Marin, J. Mas-Cabo, J. Garcia-Casado, G. Prats-Boluda


When the maternal and fetal risks of prolonging gestation are higher than the benefits, labor induction is performed in order to stimulate uterine contractions and to facilitate cervical ripening. Nevertheless, not all cases end up in successful induction leading to an increase in the rate of caesarean sections. The aim of this study was to study the electrophysiological uterine response to misoprostol drug by obtaining and analyzing the evolution of temporal and spectral parameters from uterine electromyogram (electrohysterogram, EHG) records picked up during the first 4 hours of labor induction. Successful inductions showed a progressive increase in amplitude and a frequency shift in spectral content towards higher frequencies approximately 120 min after the initiation of labor induction; such response was not seen in failed inductions. In conclusion, the electrophysiological response caused by effect of misoprostol in pregnant women has been characterized by EHG parameters which showed patterns in their evolution that were different for successful and failed labor inductions. EHG recording and analysis could serve as a very helpful tool to predict the success of labor induction and hence reduce risks and facilitate labor management in this frequent clinical situation.


  1. Martin J A, Hamilton B E, Ventura S J. et al. Births: final data for 2010. Natl Vital Stat Rep. 2012;61:1-72.
  2. Seyb ST. Risk of cesarean delivery with elective induction of labor at term in nulliparous women. Obstet Gynecol 1999, 94:600-607
  3. Gudex G. Induction of labour with prostaglandin E2 a prospective audit. NJ Med J 1993; 106: 78-80.
  4. Bishop EH. Pelvic scoring for elective induction. Obstet Gynecol 1964;24:266-8
  5. Faltin-Traub EF, Boulvain M, Faltin DL, Extermann P, Irion O. Reliability of the Bishop score labour induction at term. Eur J Obstet and Gynecol Reprod Biol 2004; 112: 178-181
  6. Watson WS, Stevens D, Welter S, Day D. Factor predicting successful labor induction. Obstet Gynecol 1996; 88: 990-992.
  7. Crane JM. Predictors of successful labor induction with oral or vaginal misoprostol. J Matern Fetal Neonat Med 2004;15: 319-323.
  8. Garfield R, Maner W, "Physiology and electrical activity of uterine contractions," Semin. Cell Dev. Biol., vol. 18, no. 3, pp. 289-295, June 2007
  9. A. Aronsson, M. Bygdeman, and K. Gemzell Danielsson, “Effects of misoprostol on uterine contractility following different routes of administration,” Hum. Reprod., vol. 19, no. 1, pp. 81-84, Jan. 2004
  10. Schlembach D, Maner WL, Garfield RE, Maul H. Monitoring the progress of pregnancy and labor using electromyography. European Journal of Obstetrics, Gynecology, and Reproductive Biology 2009; 144(Suppl 1): S33-9.
  11. Euliano TY, et al. Monitoring uterine activity during labor: A comparison of 3 methods. Am J Obstet Gynecol. 2013;208(1):66.e1-66.e6.
  12. Marque C, Duchene JM, Leclercq S, Panczer GS, Chaumont J. Uterine EHG processing for obstetrical monitoring. IEEE Trans. Biomed. Eng. 1986; 33(12): 1182-7
  13. Grobman, William A. Elective Induction: When? Ever? Clinical obstetrics and gynecology (0009-9201). 50 (2), p. 537.
  14. Mayer R, Oppelt P, Shebl O, Allerstofer, C, Weiss C. Initial clinical experience with a misoprostol vaginal insert in comparison with a dinoprostone insert for inducing labor. Euro. Jour. of Obst. and Gyneco. and Reprod. Biol. , Volume 200 , 89 - 93.
  15. Papanikolaou E, Plachouras N, Drougia A, Andronikou S, Vlachou C, Stefos T, Paraskevaidis E, Zikopoulos K. Comparison of Misoprostol and Dinoprostone for elective induction of labour in nulliparous women at full term: A randomized prospective study. Reproductive Biology and Endocrinology 2004, 2:70.
  16. Vinken M, Rabotti C, Mischi M, van Laar J, Oei S. Nifedipine-induced changes in the electrohysterogram of preterm contractions: feasibility in clinical practice. Obstet Gynecol, vol 2010, 2010, pp 1-8.
  17. Tang OS, Schweer H, Seyberth HW, Lee SW and Ho PC (2002) Pharmacokinetics of different routes of administration of misoprostol. Hum Reprod 17,332- 336.
  18. Aviram A, Melamed N, Hadar E, Raban O, Hiersch L, Yogev Y, et al. Effect of Prostaglandin E2 on Myometrial Electrical Activity in Women Undergoing Induction of Labor. J Perinatol. 2014;31:413-8.
  19. Toth T. Transcutaneous electromyography of uterus in prediction of labor outcome induced by oxytocine and prostaglandine shape. Gynaecologia et perinatologia: journal for gynaecology, perinatology, reproductive medicine and ultrasonic diagnostic, vol 14 no 2, 2005.

Paper Citation

in Harvard Style

Benalcazar Parra C., Montfort-Orti R., Ye-Lin Y., Alberola-Rubio J., Perales Marin A., Mas-Cabo J., Garcia-Casado J. and Prats-Boluda G. (2017). Characterization of Uterine Response to Misoprostol based on Electrohysterogram . In Proceedings of the 10th International Joint Conference on Biomedical Engineering Systems and Technologies - Volume 4: BIOSIGNALS, (BIOSTEC 2017) ISBN 978-989-758-212-7, pages 64-69. DOI: 10.5220/0006146700640069

in Bibtex Style

author={C. Benalcazar Parra and R Montfort-Orti and Y. Ye-Lin and J. Alberola-Rubio and A. Perales Marin and J. Mas-Cabo and J. Garcia-Casado and G. Prats-Boluda},
title={Characterization of Uterine Response to Misoprostol based on Electrohysterogram},
booktitle={Proceedings of the 10th International Joint Conference on Biomedical Engineering Systems and Technologies - Volume 4: BIOSIGNALS, (BIOSTEC 2017)},

in EndNote Style

JO - Proceedings of the 10th International Joint Conference on Biomedical Engineering Systems and Technologies - Volume 4: BIOSIGNALS, (BIOSTEC 2017)
TI - Characterization of Uterine Response to Misoprostol based on Electrohysterogram
SN - 978-989-758-212-7
AU - Benalcazar Parra C.
AU - Montfort-Orti R.
AU - Ye-Lin Y.
AU - Alberola-Rubio J.
AU - Perales Marin A.
AU - Mas-Cabo J.
AU - Garcia-Casado J.
AU - Prats-Boluda G.
PY - 2017
SP - 64
EP - 69
DO - 10.5220/0006146700640069