Abstract
Objective
The simultaneous recording of external uterine pressure in four locations on the abdominal wall with four-channel-tocography provides new ways to describe the dynamics of uterine activity.
Methods
Fifty-eight healthy primigravidas and 25 healthy multigravidas were studied prospectively with four-channel tocography during the course of pregnancy. Starting at 21 weeks’ gestation, the following five intervals were defined: 21–24, 25–28, 29–32, 33–36 and more than 37 completed weeks. Eligibility criteria included informed consent, no history of malformations of the uterus, and no previous preterm deliveries. Patients were excluded for the following reasons: medication for preterm labor, cerclage, placenta previa, delivery before 37 weeks’ gestation, less than three measurements completed, and patient’s withdrawal of consent.
Results
The median contraction frequency per hour was six for primigravidas and five for multigravidas, without significant correlation with gestational age. At all time periods studied, the median rate of global contractions developing simultaneously in at least three uterine segments was less than 15%; however, it was significantly higher in primigravidas than in multigravidas (14% versus 4%o, P < .001). Both groups had more activity in the right upper quadrant of the uterus shortly before delivery.
Conclusion
Four-channel tocography provided insight into uterine activity patterns and might enable obstetricians to select clinically relevant contractions for further treatment.
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References
Creasy RK. Preterm labor and delivery. In: Creasy RK, Resnik R, eds. Maternal fetal medicine principles and practice. Philadelphia, London, Toronto, Montreal, Sydney, Tokyo: W.B. Saunders Company, 1989.
American College of Obstetricians and Gynecologists. Preterm labor. Technical bulletin no. 206. Washington, DC: American College of Obstetricians and Gynecologists, 1995:1–10.
Lewis R, Mercer BM, Salama M, Walsh MA, Sibai BM. Oral terbutaline after parenteral tocolysis: A randomized, double-blind, placebo-controlled trial. Am J Obstet Gynecol 1996;175: 834–7.
Rust OA, Bofill JA, Arriola RM, Andrew ME, Morrison JC. The clinical efficacy of oral tocolytic therapy. Am J Obstet Gynecol 1996;175:838–42.
The Canadian Preterm Labor Investigators Group. Treatment of preterm labor with the beta-adrenergic agonist ritodrine. N Engl J Med 1992;327:308–12.
Roberts WE, Perry KG, Naef RW III, Washburne JF, Morrison JC. The irritable uterus: A risk factor for preterm birth. Am J Obstet Gynecol 1995;172:138–42.
Spätling L, Schneider H. Tokolyse - Pharmaka, Indikation und Wertung. Gynäkologe 1995;28:192–202.
Utter GO, Dooley SL, Tamura RK, Socol ML. Awaiting cervical change for the diagnosis of preterm labor does not compromise the efficacy of ritodrine tocolysis. Am J Obstet Gynecol 1990;163:882–6.
Reynolds SRM, Heard OO, Bruns P, Hellmann LM. A multichannel strain-gage tokodynamometer: An instrument for studying patterns of uterine contractions in pregnant women. Bul Johns Hopkins Hosp 1949;82:466.
Spätling L, Behrens C, Hasenburg A, Fallenstein F. External four channel tocography in preterm labor. First results. J Perinatal Med 1997:25:43–8.
Spätling L, Fallenstein F, Danders R, Hasenburg A. External four-channel tocography during delivery. Int J Gynecol Obstet 1994;46:291–5.
Main DM, Grisso JK, Wold TO, Sneyder ES, Holmes J, Chiu G. Extended longitudinal study of uterine activity among low-risk women. Am J Obstet Gynecol 1991;165:1317–22.
Katz M, Newman RB, Gill PJ. Assessment of uterine activity in ambulatory patients at high risk of preterm labor and delivery. Am J Obstet Gynecol 1986;154:44–7.
Moore TR, Iams JD, Creasy RK, Burau KD, Davidson AL, The Uterine Activity in Pregnancy Working Group. Diurnal and gestational patterns of uterine activity in normal human pregnancy. Obstet Gynecol 1994;83:517–23.
Zahn V. Physiologie der Uteruskontraktionen. Z Geburtsh Perinat 1978;182:263–8.
Caldeyro-Barcia R, Alvarez H, Reynolds SRM. A better understanding of uterine contractility through simultaneous recording with an internal and a seven channel external method. Surg Gynecol Obstet 1950;91:641–50.
Baumgarten K. Die Beeinflussung der Uterusmotilität. Vienna, Austria: Verlag Brüder Hollinek, 1967:15–49.
Jung H. Erregungsphysiologie des Uterus. Arch Gynak 1965;202: 14–23.
Reynolds SRM. Physiology of the uterus. In: Hoeber PB, ed. New York: Medical Book Departement of Harper & Brothers, 1949.
Shinmoto M, Kawarabayashi T, Ikeda M, Sugimori H. Qualitative evaluation of uterine contractions recorded by a double guard-ring tocodynamometer. Am J Obstet Gynecol 1991; 165: 1282–6.
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We thank Beate Edelhoff and Eva-Maria Zumbusch for their assistance in performing the examinations.
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Hasenburg, A., Behrens, C., Fallenstein, F. et al. Four-Channel Tocography in Uneventful Pregnancies: A Prospective Study in Primigravidas and Multigravidas. Reprod. Sci. 8, 48–53 (2001). https://doi.org/10.1177/107155760100800109
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DOI: https://doi.org/10.1177/107155760100800109