Toward a new modality for detecting a uterine rupture: electrohysterogram propagation analysis during trial of labor after cesarean

Abstract

Objective: Observational cohort study which aimed to explore the potential of electrohysterogram (EHG) analysis for detecting a uterine rupture during trial of labor after cesarean. The EHG propagation characteristics surrounding the uterine scar of six patients with a previous cesarean section were compared to a control group of five patients without a scarred uterus.

Methods: The EHG was recorded during the first stage of labor using a high-resolution 64-channel electrode grid positioned on the maternal abdomen across the cesarean scar. Based on simulations, the inter-channel correlation and propagation direction were adopted as EHG parameters for evaluating possible disruption of electrical propagation by the uterine scar.

Results: No significant differences in inter-channel correlation or propagation direction were observed between the group of patients with an intact uterine scar and the control group. A strong predominance of vertical propagation was observed in one case, in which scar rupture occurred.

Conclusions: The results support unaffected propagation of electrical activity through the intact uterine scar tissue suggesting that changes in the EHG might only occur in case of rupture.

Keywords:

• Electrohysterogram
• labor and delivery
• trial of labor after cesarean
• uterine electromyography
• uterine rupture
• vaginal birth after cesarean

Acknowledgements

We wish to acknowledge the staff at the Maxima Medical Center in the Netherlands and specially Joris Renckens, Olenka Hulsenboom, and Noortje Eijsvoogel for assistance in patient selection and data collection.

Declaration of interest

The authors report no declarations of interest.

Supplementary material available online