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The association between myometrial electrical activity and time to delivery in threatened preterm labor
Amir Aviram1, Liran Hiersch1, Eran Ashwal1
1a Helen Schneider Hospital for Women, Rabin Medical Center, Israel and the Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel.
Objective:
To assess the association between myometrial electrical activity and time-to-delivery in preterm labor using uterine electromyography.
Methods:
Myometrial electrical activity was measured via the electrical uterine monitor (EUM) device. Data was prospectively collected among women admitted due to suspected preterm labor, prior to 34 weeks of gestation. EUM-Index was defined as the mean electrical activity of the uterine muscle over a period of 10 minutes measured in units of microjoule (μJ, microwatt second). The association between the EUM-Index at admission to time-to-delivery and delivery prior to 34 weeks of gestation was calculated.
Results:
Overall, 45 women were included in the study. EUM-Index combined with cervical dilatation, demonstrated significant correlation to time-to-delivery (R(2 )= 0.49, p = 0.005), which was strengthened for women presenting prior to 28 weeks of gestation. EUM-Index above the median (>3.05 MJ) was significantly associated with a shorter latency period for delivery (36.0 ± 19.4 vs. 50.2 ± 25.9 days, p = 0.04). For delivery prior to 34 weeks, the EUM-Index showed an AUC = 0.65 (95% CI 0.48-0.82), and a cutoff of 2.5 MJ provided 91.7% sensitivity and 93.3% negative predictive value.
Conclusion:
EUM-Index at time of admission due to suspected preterm labor is inversely correlated with time-to-delivery and may effectively rule out preterm delivery prior to 34 weeks.
