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

Area of Science:

• Biomedical Engineering
• Obstetrics and Gynecology
• Signal Processing

Background:

• Uterine contraction monitoring is crucial for predicting labor onset.
• Traditional tocodynamometry lacks information on contraction synchrony and coherence.
• Electrohysterography (EHG) offers spatial-temporal data for characterizing uterine activity.

Purpose of the Study:

• To develop and validate a novel method using EHG signals to quantify uterine contraction synchrony and coherence.
• To assess the effectiveness of EHG-derived features in predicting imminent labor.

Main Methods:

• Contractile time-windows were identified from tocodynamometer (TOCO) signals.
• Simultaneously recorded multi-channel EHG signals were segmented.
• Sample entropy (SamEn) and Concordance Correlation based feature (ψ) were computed from EHG segments to quantify synchrony and coherence.
• 122 EHG recordings from the Icelandic EHG database were analyzed.

Main Results:

• Both SamEn and ψ showed significant differences between groups with varying time-to-delivery (TTD) (p<10⁻⁵).
• Receiver operating characteristic curve analysis yielded AUC values of 0.834 for SamEn and 0.726 for ψ in discriminating imminent labor (TTD ≤ 24 h).
• SamEn was significantly lower in the imminent labor group (0.1433) compared to the general pregnancy group (0.3774).
• Optimal SamEn cutoff achieved 0.909 sensitivity, 0.712 specificity, and 0.743 accuracy for identifying imminent labor.

Conclusions:

• EHG signal analysis provides a novel and effective approach for characterizing uterine contraction synchrony and coherence.
• The proposed method demonstrates superior performance in predicting imminent labor compared to existing methods.
• This study opens a new research direction for utilizing EHG in obstetrics for improved labor prediction.