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Could electrohysterography be the solution for external uterine monitoring in obese women?

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Abstract

Objective

To evaluate the influence of maternal obesity on the performance of external tocodynamometry and electrohysterography.

Study design

In a 2-hour measurement during term labor, uterine contractions were simultaneously measured by electrohysterography, external tocodynamometry, and intra-uterine pressure catheter. The sensitivity was compared between groups based on obesity (non-obese/obese/morbidly obese) or uterine palpation (good/moderate/poor), and was correlated to maternal BMI and abdominal circumference.

Result

We included 14 morbidly obese, 18 obese, and 20 non-obese women. In morbidly obese women, the median sensitivity was 87.2% (IQR 74–93) by electrohysterography and 45.0% (IQR 36–66) by external tocodynamometry (p < 0.001). The sensitivity of electrohysterography appeared to be non-influenced by obesity category (p = 0.279) and uterine palpation (p = 0.451), while the sensitivity of tocodynamometry decreased significantly (p = 0.005 and p < 0.001, respectively). Furthermore, the sensitivity of both external methods was negatively correlated with obesity parameters, being non-significant for electrohysterography (range p-values 0.057–0.088) and significant for external tocodynamometry (all p-values < 0.001).

Conclusions

Electrohysterography performs significantly better than external tocodynamometry in case of maternal obesity.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Máxima Medical Center, P.O. Box 7777, 5500 MB, Veldhoven, The Netherlands

    Marion W. C. Vlemminx, Kirsten M. J. Thijssen, M. Beatrijs Van Der Hout-Van Der Jagt & S. Guid Oei

  2. Department of Electrical Engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands

    Marion W. C. Vlemminx, Kirsten M. J. Thijssen, Galin I. Bajlekov, M. Beatrijs Van Der Hout-Van Der Jagt & S. Guid Oei

  3. MMC Academy, Máxima Medical Center, P.O. Box 7777, 5500 MB, Veldhoven, The Netherlands

    Jeanne P. Dieleman

Authors
  1. Marion W. C. Vlemminx
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  2. Kirsten M. J. Thijssen
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  3. Galin I. Bajlekov
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  4. Jeanne P. Dieleman
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  5. M. Beatrijs Van Der Hout-Van Der Jagt
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  6. S. Guid Oei
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Corresponding author

Correspondence to Marion W. C. Vlemminx.

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Conflict of interest

Author Professor Oei is a gynecologist and the Head of the Obstetric Department of Máxima Medical Center and leader of the fundamental perinatology research group from Eindhoven University of Technology. From this scientific research, the described EHG device and the company Nemo Healthcare has originated. Máxima Medical Centre has a research collaboration with Nemo Healthcare. Professor Oei has no affiliations with or involvement in Nemo Healthcare with any financial interest. During the study, authors MV, KT, and BvdH were financially supported by a general gift of the independent Dutch ‘Stichting De Weijerhorst’ for electro-fetal-maternal monitoring. From 2016, author KT is being paid by a grant from the European Framework Research and Innovation Program ‘Horizon 2020’ (Grant number 719500). Authors GB and JD have no conflicts of interest.

Additional information

Clinical trial registry:W3-study, Dutch Trial Registry, NTR5894 http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5894

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Vlemminx, M.W.C., Thijssen, K.M.J., Bajlekov, G.I. et al. Could electrohysterography be the solution for external uterine monitoring in obese women?. J Perinatol 38, 580–586 (2018). https://doi.org/10.1038/s41372-018-0065-3

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