Uterine Activity Monitoring during Labour – A Multi-Centre, Blinded Two-Way Trial of External Tocodynamometry against Electrohysterography

 

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Abstract

Purpose:

The aim of this study was to determine the quality of intrapartum uterine activity (UA) monitoring in daily practice during the first and second stages of labour. The total duration of inadequate UA monitoring is quantified in relation to the technique applied, namely, external tocodynamometry (TOCO) or electrohysterography (EHG).

Material and Methods:

144 UA recordings, collected from 1^st September 2008 until 15^th October 2009 from deliveries at the Marien-Hospital Witten, Germany, were analysed by obstetricians based at different centres. The included recordings were from singleton and simultaneously with external TOCO and EHG monitored pregnancies. External TOCO and EHG UA recordings were blinded.

Results:

The percentages of “adequate” UA recordings in the first and second stages of labour were much higher for the external EHG than the external TOCO mode (p<0.001). All doctors evaluated the UA assessment as “easier” (p <0.001) using the EHG compared with TOCO.

Conclusion:

Intrapartum UA monitoring in ­daily practice via the EHG mode provides a more re­cognisable UA trace than the TOCO.

Zusammenfassung

Fragestellung:

Ziel dieser Studie ist die Qua­litätsbeurteilung der Wehentätigkeitsaufzeichnung (UA) in der ersten und zweiten Geburts­phase. Die adäquate Aufzeichnungsperiode und Qualität wurde nach Aufzeichnungstechnik (Tokogramm (TOCO) vs. Elektrohystogramm (EHG)) evaluiert.

Material und Methodik:

144 UA-Aufzeichnungen, bei denen gleichzeitig TOCO und EHG abgeleitet wurden, wurden durch Gynäkologen/in bei unterschiedlichen Zentren beurteilt. Die Auf­zeichnungen wurden verblindet ausgewertet.

Ergebnisse:

Adäquate UA-Aufzeichnungen waren häufiger bei dem EHG im Vergleich zum TOCO (während der ersten und zweiten Geburts­phase; p<0,001). Alle Ärzte beurteilten EHG-Qualität Wehentätigkeit als besser (p<0,001).

Schlussfolgerung:

Unter der Geburt zeigt das EHG mehr adäquate UA-Aufzeichnung und bessere Beurteilbarkeit als der „Goldstandard“ TOCO.

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