Preterm labour detection by use of a biophysical marker: the uterine electrical activity.
Preterm labour detection by use of a biophysical marker: the uterine electrical activity.
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DOI：
10.1186/1471-2393-7-s1-s5
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发表时间：
2007-06-01
影响因子：
3.1
通讯作者：
Germain G
中科院分区：
文献类型：
--
作者：
Marque CK;Terrien J;Rihana S;Germain G
子宫肌肉的电活动代表子宫收缩力。其特征可用于检测女性早产的潜在风险，即使是在妊娠早期。我们通过使用女性腹部的数学模型研究了记录电极位置对信号频谱内容的影响。然后我们将模拟结果与实际记录进行比较。对于使用专用算法降噪的信号，我们表征了信号频谱的主要频率分量，以便计算指示不同情况的参数：导致足月分娩的早产宫缩（即正常宫缩）和导致早产的早产宫缩（即高风险宫缩）。诊断系统使我们能够区分这些不同类别的宫缩。由于胎盘的位置似乎会影响电活动的频率内容，因此我们还在子宫上附着内部电极的猴子中研究了胎盘对电信号频谱内容的影响。对于女性，最佳电极位置是腹部的中垂直轴。高风险宫缩和正常宫缩之间的区分表明，早在怀孕第 27 周就有可能检测到早产风险（错误分类率范围：11-19.5%）。胎盘对电信号的影响在动物记录中得到了证明，与胎盘插入上方记录的信号相比，远离胎盘记录的信号在高频段具有更高的能量含量。然而，我们注意到，从怀孕到分娩，无论电极和胎盘的相对位置如何，信号的频率内容都会向高频发生类似的演变。这项研究证明，通过人体记录，最早在怀孕第 27 周就可以通过非侵入性腹部记录来检测早产风险。关于动物信号，我们已经证明胎盘对子宫电活动的特征产生局部影响。然而，当使用正确的诊断工具时，这些差异对早产风险诊断的影响很小。
The electrical activity of the uterine muscle is representative of uterine contractility. Its characterization may be used to detect a potential risk of preterm delivery in women, even at an early gestational stage. We have investigated the effect of the recording electrode position on the spectral content of the signal by using a mathematical model of the women's abdomen. We have then compared the simulated results to actual recordings. On signals with noise reduced with a dedicated algorithm, we have characterized the main frequency components of the signal spectrum in order to compute parameters indicative of different situations: preterm contractions resulting nonetheless in term delivery (i.e. normal contractions) and preterm contractions leading to preterm delivery (i.e. high-risk contractions). A diagnosis system permitted us to discriminate between these different categories of contractions. As the position of the placenta seems to affect the frequency content of electrical activity, we have also investigated in monkeys, with internal electrodes attached on the uterus, the effect of the placenta on the spectral content of the electrical signals. In women, the best electrode position was the median vertical axis of the abdomen. The discrimination between high risk and normal contractions showed that it was possible to detect a risk of preterm labour as early as at the 27th week of pregnancy (Misclassification Rate range: 11–19.5%). Placental influence on electrical signals was evidenced in animal recordings, with higher energy content in high frequency bands, for signals recorded away from the placenta when compared to signals recorded above the placental insertion. However, we noticed, from pregnancy to labour, a similar evolution of the frequency content of the signal towards high frequencies, whatever the relative position of electrodes and placenta. On human recordings, this study has proved that it is possible to detect, by non-invasive abdominal recordings, a risk of preterm birth as early as the 27th week of pregnancy. On animal signals, we have evidenced that the placenta exerts a local influence on the characteristics of the electrical activity of the uterus. However, these differences have a small influence on premature delivery risk diagnosis when using proper diagnosis tools.