Alba Diaz-Martinez , Gema Prats-Boluda , Rogelio Monfort-Ortiz , Javier Garcia-Casado , Alba Roca-Prats , Enrique Tormo-Crespo , Félix Nieto-del-Amor , Vicente-José Diago-Almela , Yiyao Ye-Lin
{"title":"过度滞产会加速多胎妊娠临产时子宫肌肉的电生理变化","authors":"Alba Diaz-Martinez , Gema Prats-Boluda , Rogelio Monfort-Ortiz , Javier Garcia-Casado , Alba Roca-Prats , Enrique Tormo-Crespo , Félix Nieto-del-Amor , Vicente-José Diago-Almela , Yiyao Ye-Lin","doi":"10.1016/j.irbm.2024.100837","DOIUrl":null,"url":null,"abstract":"<div><h3>Background for the research</h3><p>Premature birth and its associated complications are one of the biggest global health problems, since there is currently no effective screening method in clinical practice to accurately identify the true Preterm Birth (PTB) from the false threatened ones. Despite the high prevalence of PTB in multiple gestation (MG) women which amounted up to 60%, in the literature there is any work about their uterine myoelectric activities in vivo system. Electrohysterography (EHG) has been emerged as an alternative technique for predicting PTB in single gestation (SG) women.</p></div><div><h3>Purpose</h3><p>The aim of this study was to characterize and compare the uterine myoelectrical activity in vivo system of SG and MG women in regular check-ups, to provide the basis for early detection and prevention of preterm labour in MG.</p></div><div><h3>Basic procedures</h3><p>A prospective observational cohort study was conducted on 31 SG and 18 MG women between the 28<sup>th</sup> and 32<sup>th</sup> WoG who underwent regular check-ups in the Polytechnic and University Hospital La Fe (Valencia, Spain). The 30-minute bipolar recording was filtered in the 0.1-4 Hz bandwidth and downsampled to 20 Hz. Signal analysis was performed in 120-second moving windows with 50% overlap, after removing artefacts by a double- blind expert process. A set of 8 temporal, spectral and non-linear parameters were calculated: root mean square (RMS), kurtosis of the Hilbert envelope (KHE), median frequency (MDF), H/L ratio, and sample entropy (SampEn) and bubble entropy (BubbEn) calculated in the whole bandwidth (WBW) and the fast wave high (FWH). The 10th, 50th and 90th percentiles of all windows analysed were calculated to obtain representative values of the recordings. For each parameter and percentile, statistically significant differences between the SG and MG groups and their statistical power (SP) were analysed to determine both the existence of an effect and substantive significance, respectively.</p></div><div><h3>Main findings</h3><p>In comparison to SG, MG EHG exhibited significant higher impulsiveness and higher predictability than SG which was reflected in the KHE (SP<sub>10</sub> = 85.2, p<sub>10</sub> < 0.001) and entropy measures (SampEn FWH: SP<sub>50</sub> = 62.0, p<sub>50</sub> = 0.0.016; SP<sub>90</sub> = 52.5, p<sub>90</sub> = 0.059. BubbEn FWH: SP<sub>50</sub> = 75.2, p<sub>50</sub> < 0.001; SP<sub>90</sub> = 60.3, p<sub>90</sub> = 0.002), suggesting an accelerated evolution of uterine electrophysiological condition. In addition, several EHG parameters were found to significantly correlate with foetal weight such as amplitude (RMS: r<sub>90</sub> = 0.311, p<sub>90</sub> = 0.006), signal impulsiveness (KHE: r<sub>10</sub> = 0.311, p<sub>10</sub> = 0.006) and entropy measures (SampEn FWH: r<sub>50</sub> = −0.317, p<sub>50</sub> = 0.005*; r<sub>90</sub> = −0.279, p<sub>90</sub> = 0.013*. BubbEn FWH: r<sub>50</sub> = −0.370, p<sub>50</sub> = 0.001*; r<sub>90</sub> = −0.313, p<sub>90</sub> = 0.005*), suggesting an electromechanical coupling between uterine overdistension and contractile activity in vivo system.</p></div><div><h3>Principal conclusions</h3><p>In comparison to SG women, MG showed higher impulsiveness and predictability in early third gestational trimester, as reflected in KHE, SampEn and BubbEn, respectively. We found similar cell excitability between SG and MG women far from delivery. In addition, we confirmed the relationship between uterine overdistension and surface myoelectric activity, revealing the electromechanical coupling pathway in uterine smooth muscle. Therefore, contextualized EHG-biomarkers would provide valuable information for early detection of PTB risk, which would allow clinicians better PTB management through personalised therapeutic interventions.</p></div>","PeriodicalId":14605,"journal":{"name":"Irbm","volume":"45 3","pages":"Article 100837"},"PeriodicalIF":5.6000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1959031824000186/pdfft?md5=255e8c281ae55cb57d5e7fff904cfa61&pid=1-s2.0-S1959031824000186-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Overdistention Accelerates Electrophysiological Changes in Uterine Muscle Towards Labour in Multiple Gestations\",\"authors\":\"Alba Diaz-Martinez , Gema Prats-Boluda , Rogelio Monfort-Ortiz , Javier Garcia-Casado , Alba Roca-Prats , Enrique Tormo-Crespo , Félix Nieto-del-Amor , Vicente-José Diago-Almela , Yiyao Ye-Lin\",\"doi\":\"10.1016/j.irbm.2024.100837\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background for the research</h3><p>Premature birth and its associated complications are one of the biggest global health problems, since there is currently no effective screening method in clinical practice to accurately identify the true Preterm Birth (PTB) from the false threatened ones. Despite the high prevalence of PTB in multiple gestation (MG) women which amounted up to 60%, in the literature there is any work about their uterine myoelectric activities in vivo system. Electrohysterography (EHG) has been emerged as an alternative technique for predicting PTB in single gestation (SG) women.</p></div><div><h3>Purpose</h3><p>The aim of this study was to characterize and compare the uterine myoelectrical activity in vivo system of SG and MG women in regular check-ups, to provide the basis for early detection and prevention of preterm labour in MG.</p></div><div><h3>Basic procedures</h3><p>A prospective observational cohort study was conducted on 31 SG and 18 MG women between the 28<sup>th</sup> and 32<sup>th</sup> WoG who underwent regular check-ups in the Polytechnic and University Hospital La Fe (Valencia, Spain). The 30-minute bipolar recording was filtered in the 0.1-4 Hz bandwidth and downsampled to 20 Hz. Signal analysis was performed in 120-second moving windows with 50% overlap, after removing artefacts by a double- blind expert process. A set of 8 temporal, spectral and non-linear parameters were calculated: root mean square (RMS), kurtosis of the Hilbert envelope (KHE), median frequency (MDF), H/L ratio, and sample entropy (SampEn) and bubble entropy (BubbEn) calculated in the whole bandwidth (WBW) and the fast wave high (FWH). The 10th, 50th and 90th percentiles of all windows analysed were calculated to obtain representative values of the recordings. For each parameter and percentile, statistically significant differences between the SG and MG groups and their statistical power (SP) were analysed to determine both the existence of an effect and substantive significance, respectively.</p></div><div><h3>Main findings</h3><p>In comparison to SG, MG EHG exhibited significant higher impulsiveness and higher predictability than SG which was reflected in the KHE (SP<sub>10</sub> = 85.2, p<sub>10</sub> < 0.001) and entropy measures (SampEn FWH: SP<sub>50</sub> = 62.0, p<sub>50</sub> = 0.0.016; SP<sub>90</sub> = 52.5, p<sub>90</sub> = 0.059. BubbEn FWH: SP<sub>50</sub> = 75.2, p<sub>50</sub> < 0.001; SP<sub>90</sub> = 60.3, p<sub>90</sub> = 0.002), suggesting an accelerated evolution of uterine electrophysiological condition. In addition, several EHG parameters were found to significantly correlate with foetal weight such as amplitude (RMS: r<sub>90</sub> = 0.311, p<sub>90</sub> = 0.006), signal impulsiveness (KHE: r<sub>10</sub> = 0.311, p<sub>10</sub> = 0.006) and entropy measures (SampEn FWH: r<sub>50</sub> = −0.317, p<sub>50</sub> = 0.005*; r<sub>90</sub> = −0.279, p<sub>90</sub> = 0.013*. BubbEn FWH: r<sub>50</sub> = −0.370, p<sub>50</sub> = 0.001*; r<sub>90</sub> = −0.313, p<sub>90</sub> = 0.005*), suggesting an electromechanical coupling between uterine overdistension and contractile activity in vivo system.</p></div><div><h3>Principal conclusions</h3><p>In comparison to SG women, MG showed higher impulsiveness and predictability in early third gestational trimester, as reflected in KHE, SampEn and BubbEn, respectively. We found similar cell excitability between SG and MG women far from delivery. In addition, we confirmed the relationship between uterine overdistension and surface myoelectric activity, revealing the electromechanical coupling pathway in uterine smooth muscle. 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Overdistention Accelerates Electrophysiological Changes in Uterine Muscle Towards Labour in Multiple Gestations
Background for the research
Premature birth and its associated complications are one of the biggest global health problems, since there is currently no effective screening method in clinical practice to accurately identify the true Preterm Birth (PTB) from the false threatened ones. Despite the high prevalence of PTB in multiple gestation (MG) women which amounted up to 60%, in the literature there is any work about their uterine myoelectric activities in vivo system. Electrohysterography (EHG) has been emerged as an alternative technique for predicting PTB in single gestation (SG) women.
Purpose
The aim of this study was to characterize and compare the uterine myoelectrical activity in vivo system of SG and MG women in regular check-ups, to provide the basis for early detection and prevention of preterm labour in MG.
Basic procedures
A prospective observational cohort study was conducted on 31 SG and 18 MG women between the 28th and 32th WoG who underwent regular check-ups in the Polytechnic and University Hospital La Fe (Valencia, Spain). The 30-minute bipolar recording was filtered in the 0.1-4 Hz bandwidth and downsampled to 20 Hz. Signal analysis was performed in 120-second moving windows with 50% overlap, after removing artefacts by a double- blind expert process. A set of 8 temporal, spectral and non-linear parameters were calculated: root mean square (RMS), kurtosis of the Hilbert envelope (KHE), median frequency (MDF), H/L ratio, and sample entropy (SampEn) and bubble entropy (BubbEn) calculated in the whole bandwidth (WBW) and the fast wave high (FWH). The 10th, 50th and 90th percentiles of all windows analysed were calculated to obtain representative values of the recordings. For each parameter and percentile, statistically significant differences between the SG and MG groups and their statistical power (SP) were analysed to determine both the existence of an effect and substantive significance, respectively.
Main findings
In comparison to SG, MG EHG exhibited significant higher impulsiveness and higher predictability than SG which was reflected in the KHE (SP10 = 85.2, p10 < 0.001) and entropy measures (SampEn FWH: SP50 = 62.0, p50 = 0.0.016; SP90 = 52.5, p90 = 0.059. BubbEn FWH: SP50 = 75.2, p50 < 0.001; SP90 = 60.3, p90 = 0.002), suggesting an accelerated evolution of uterine electrophysiological condition. In addition, several EHG parameters were found to significantly correlate with foetal weight such as amplitude (RMS: r90 = 0.311, p90 = 0.006), signal impulsiveness (KHE: r10 = 0.311, p10 = 0.006) and entropy measures (SampEn FWH: r50 = −0.317, p50 = 0.005*; r90 = −0.279, p90 = 0.013*. BubbEn FWH: r50 = −0.370, p50 = 0.001*; r90 = −0.313, p90 = 0.005*), suggesting an electromechanical coupling between uterine overdistension and contractile activity in vivo system.
Principal conclusions
In comparison to SG women, MG showed higher impulsiveness and predictability in early third gestational trimester, as reflected in KHE, SampEn and BubbEn, respectively. We found similar cell excitability between SG and MG women far from delivery. In addition, we confirmed the relationship between uterine overdistension and surface myoelectric activity, revealing the electromechanical coupling pathway in uterine smooth muscle. Therefore, contextualized EHG-biomarkers would provide valuable information for early detection of PTB risk, which would allow clinicians better PTB management through personalised therapeutic interventions.
期刊介绍:
IRBM is the journal of the AGBM (Alliance for engineering in Biology an Medicine / Alliance pour le génie biologique et médical) and the SFGBM (BioMedical Engineering French Society / Société française de génie biologique médical) and the AFIB (French Association of Biomedical Engineers / Association française des ingénieurs biomédicaux).
As a vehicle of information and knowledge in the field of biomedical technologies, IRBM is devoted to fundamental as well as clinical research. Biomedical engineering and use of new technologies are the cornerstones of IRBM, providing authors and users with the latest information. Its six issues per year propose reviews (state-of-the-art and current knowledge), original articles directed at fundamental research and articles focusing on biomedical engineering. All articles are submitted to peer reviewers acting as guarantors for IRBM''s scientific and medical content. The field covered by IRBM includes all the discipline of Biomedical engineering. Thereby, the type of papers published include those that cover the technological and methodological development in:
-Physiological and Biological Signal processing (EEG, MEG, ECG…)-
Medical Image processing-
Biomechanics-
Biomaterials-
Medical Physics-
Biophysics-
Physiological and Biological Sensors-
Information technologies in healthcare-
Disability research-
Computational physiology-
…