%0 Journal Article
%T Automated Conduction Velocity Analysis in the Electrohysterogram for Prediction of Imminent Delivery: A Preliminary Study
%A Hinke de Lau
%A Chiara Rabotti
%A Rianne Bijloo
%A Michael Johannes Rooijakkers
%A Massimo Mischi
%A S. Guid Oei
%J Computational and Mathematical Methods in Medicine
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/627976
%X Background. Analysis of the electrohysterogram (EHG) is a promising diagnostic tool for preterm delivery. For the introduction in the clinical practice, analysis of the EHG should be reliable and automated to guarantee reproducibility. Study Goal. Investigating the feasibility of automated analysis of the EHG conduction velocity (CV) for detecting imminent delivery. Materials and Methods. Twenty-two patients presenting with uterine contractions (7 preterm) were included. An EHG was obtained noninvasively using a 64-channel high-density electrode grid. Contractions were selected based on the estimated intrauterine pressure derived from the EHG, the tocodynamometer, and maternal perception. Within the selected contractions, the CV vector was identified in two dimensions. Results. Nine patients delivered within 24 hours and were classified as a labor group. 64 contractions were analyzed; the average amplitude of the CV vector was significantly higher for the labor group, 8.65£¿cm/s ¡À 1.90, compared to the nonlabor group, 5.30£¿cm/s ¡À 1.47 . Conclusion. The amplitude of the CV is a promising parameter for predicting imminent (preterm) delivery. Automated estimation of this parameter from the EHG signal is feasible and should be regarded as an important prerequisite for future clinical studies and applications. 1. Introduction Preterm delivery, defined as delivery before 37 weeks of gestation, constitutes a major problem in terms of neonatal mortality, morbidity, and healthcare costs [1¨C3]. Timely intervention and treatment with tocolytics and corticosteroids improves neonatal outcome [4]. However, the diagnostics currently used lack both sensitivity and specificity leading to both under- and overtreatment [5, 6]. A potential new diagnostic tool is the electrohysterogram (EHG), which is a noninvasive abdominal measurement of the electrical activity underlying uterine contractions. The sequence of contraction and relaxation of the uterus results from a cyclic depolarization and repolarization of its smooth muscle cells in the form of action potentials (APs). APs occur in bursts; they arise in cells that act as pacemakers and propagate from cell to cell through gap junctions [7¨C9]. Labor and delivery are preceded by two physiological phenomena: increased excitability and increased connectivity among the cells, resulting in increased propagation of APs and more synchronized firing [10]. These changes are reflected in the recorded EHG. The previous literature demonstrated that the EHG has great potential for monitoring labor, predicting labor time, and
%U http://www.hindawi.com/journals/cmmm/2013/627976/