Multi-channel electrohysterography enabled uterine contraction characterization and its effect in delivery assessment

Junhua Shen; Yan Liu; Meiyu Zhang; Alain Pumir; Liangshan Mu; Baohua Li; Jinshan Xu

doi:10.1016/j.compbiomed.2023.107697

Multi-channel electrohysterography enabled uterine contraction characterization and its effect in delivery assessment

Comput Biol Med. 2023 Dec:167:107697. doi: 10.1016/j.compbiomed.2023.107697. Epub 2023 Nov 8.

Authors

Junhua Shen¹, Yan Liu², Meiyu Zhang², Alain Pumir³, Liangshan Mu⁴, Baohua Li⁵, Jinshan Xu⁶

Affiliations

¹ Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China; Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Hangzhou, China.
² College of Computer Science, Zhejiang University of Technology, Hangzhou, China.
³ Laboratoire de Physique, Ecole Normal Superieure de Lyon, Lyon, France.
⁴ Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
⁵ Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China. Electronic address: lbh19787@zju.edu.cn.
⁶ College of Computer Science, Zhejiang University of Technology, Hangzhou, China. Electronic address: jxu@zjut.edu.cn.

PMID: 37976821
DOI: 10.1016/j.compbiomed.2023.107697

Abstract

Uterine contractions are routinely monitored by tocodynamometer (TOCO) at late stage of pregnancy to predict the onset of labor. However, TOCO reveals no information on the synchrony and coherence of contractions, which are important contributors to a successful delivery. The electrohysterography (EHG) is a recording of the electrical activities that trigger the local muscles to contract. The spatial-temporal information embedded in multiple channel EHG signals make them ideal for characterizing the synchrony and coherence of uterine contraction. To proceed, contractile time-windows are identified from TOCO signals and are then used to segment out the simultaneously recorded EHG signals of different channels. We construct sample entropy SamEn and Concordance Correlation based feature ψ from these EHG segments to quantify the synchrony and coherence of contraction. To test the effectiveness of the proposed method, 122 EHG recordings in the Icelandic EHG database were divided into two groups according to the time difference between the gestational ages at recording and at delivery (TTD). Both SamEn and ψ show clear difference in the two groups (p<10^-5) even when measurements were made 120 h before delivery. Receiver operating characteristic curve analysis of these two features gave AUC values of 0.834 and 0.726 for discriminating imminent labor defined with TTD ≤ 24 h. The SamEn was significantly smaller in women (0.1433) of imminent labor group than in women (0.3774) of the pregnancy group. Using an optimal cutoff value of SamEn to identify imminent labor gives sensitivity, specificity, and accuracy as high as 0.909, 0.712 and 0.743, respectively. These results demonstrate superiority in comparing to the existing SOTA methods. This study is the first research work focusing on characterizing the synchrony property of contractions from the electrohysterography signals. Despite the very limited dataset used in the validation process, the promising results open a new direction to the use of electrohysterography in obstetrics.

Keywords: Delivery assessment; Electrohysterography; Uterine contraction.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Electromyography / methods
Female
Humans
Labor, Obstetric* / physiology
Muscle Contraction
Pregnancy
Uterine Contraction / physiology
Uterine Monitoring* / methods
Uterus / physiology