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Related Experiment Videos

Recording maternal vaginal apex pulse.

G Loy1, R C Goodlin

  • 1Department of Obstetrics and Gynecology, University of Colorado Medical School, Denver.

American Journal of Obstetrics and Gynecology
|June 1, 1989
PubMed
Summary
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Photoelectric plethysmography of the vaginal apex shows higher sensitivity for adverse pregnancy outcomes than uterine artery Doppler velocimetry. This novel method may improve monitoring in high-risk pregnancies.

Area of Science:

  • Obstetrics and Gynecology
  • Medical Imaging
  • Physiological Monitoring

Background:

  • High-risk pregnancies require accurate monitoring for adverse outcomes.
  • Uterine artery Doppler velocimetry is a standard method, but its accuracy and waveform fixity are debated.
  • Non-invasive monitoring techniques are needed to complement existing methods.

Purpose of the Study:

  • To evaluate the accuracy, sensitivity, and specificity of vaginal apex photoelectric plethysmography compared to uterine artery Doppler velocimetry.
  • To determine if abnormal uterine artery waveforms are fixed or reversible.
  • To assess the clinical utility of vaginal apex pulse recordings in high-risk pregnancies.

Main Methods:

  • A photoelectric plethysmographic probe was used to record vaginal apex pulse waveforms in 122 high-risk pregnant women.

Related Experiment Videos

  • Uterine artery Doppler velocimetry was performed concurrently for comparison.
  • Vaginal apex pulse recordings were analyzed for waveform characteristics, including the presence or absence of a diastolic notch.

    • Main Results:

    • Vaginal apex recordings demonstrated greater sensitivity to adverse pregnancy outcomes than uterine artery Doppler velocimetry.
    • Significant decreases in vaginal apex pulse height were observed during elective cesarean sections and uterine contractions.
    • Treatment with terbutaline sulfate or magnesium sulfate led to the disappearance of diastolic notches in 8 out of 14 patients with abnormal waveforms.

    Conclusions:

    • Photoelectric plethysmography of the vaginal apex is a sensitive indicator of adverse pregnancy outcomes in high-risk pregnancies.
    • The technique offers a potentially more accurate and sensitive alternative or adjunct to uterine artery Doppler velocimetry.
    • Reversibility of abnormal waveforms with tocolytic agents suggests dynamic physiological changes rather than fixed pathology.