Open AccessUterine electromyography during active phase compared with latent phase of labor at term
Author(s) -
Trojner Bregar Andreja,
Lucovnik Miha,
Verdenik Ivan,
Jager Franc,
Gersak Ksenija,
Garfield Robert E.
Publication year - 2016
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.12818
Subject(s) - medicine , electromyography , receiver operating characteristic , gestation , area under the curve , cervical dilatation , pregnancy , physical medicine and rehabilitation , cervix , cancer , biology , genetics
In a prospective study in a tertiary university hospital we wanted to determine whether uterine electromyography ( EMG ) can differentiate between the active and latent phase of labor. Material and methods Thirty women presenting at ≥37 0/7 weeks of gestation with regular uterine contractions, intact membranes, and a Bishop score <6. EMG was recorded from the abdominal surface for 30 min. Latent phase was defined as no cervical change within at least 4 h. Student's t ‐test was used for statistical analysis ( p ≤ 0.05 significant). Diagnostic accuracy of EMG was determined by receiver operator characteristics ( ROC ) analysis. The integral of the amplitudes of the power density spectrum ( PDS ) corresponding to the PDS energy within the “bursts” of uterine EMG activity was compared between the active and latent labor groups. Results Seventeen (57%) women were found to be in the active phase of labor and 13 (43%) were in the latent phase. The EMG PDS integral was significantly higher ( p = 0.02) in the active (mean 3.40 ± 0.82 μV) compared with the latent (mean 1.17 ± 0.33 μV) phase of labor. The PDS integral had an area under the ROC curve ( AUC ) of 0.80 to distinguish between active and latent phases of labor, compared with number of contractions on tocodynamometry (AUC = 0.79), and Bishop score (AUC = 0.78). The combination (sum) of PDS integral, tocodynamometry, and Bishop score predicted active phase of labor with an AUC of 0.90. Conclusions Adding uterine EMG measurements to the methods currently used in the clinics could improve the accuracy of diagnosing active labor.