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Am J Perinatol 2019; 36(09): 924-929
DOI: 10.1055/s-0038-1675621
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Evaluating Fundal Dominant Contractions on Spatiotemporal Electrohysterography as a Marker for Effective Labor Contractions

Rodney K. Edwards
1   Section of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
,
Neil R. Euliano
2   Convergent Engineering, Newberry, Florida
,
Savyasachi Singh
2   Convergent Engineering, Newberry, Florida
,
Rachel C. LeDuke
3   Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama
,
William W. Andrews
3   Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama
,
Victoria Jauk
3   Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama
,
Akila Subramaniam
3   Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama
,
Jeff M. Szychowski
4   Departments of Biostatistics and Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama
› Author Affiliations Funding This work was supported by grant 1 R21 HD076352-01A1 from the Eunice Kennedy Shriver National Institute for Child Health and Human Development. Contents are the authors' sole responsibility and do not necessarily represent official NIH views.
Further Information

Publication History

11 July 2018

21 September 2018

Publication Date:
10 November 2018 (online)

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Abstract

Objective To evaluate if fundal (F) dominance of the electrohysterogram is associated with vaginal delivery and lack of F dominance is associated with cesarean for labor dystocia.

Study Design We conducted a prospective cohort study of nulliparous women in spontaneous labor at ≥36 weeks. Clinicians were blinded to electrohysterography data which were in addition to standard cardiotocography. All contractions in the hour preceding diagnosis of complete cervical dilation (for women delivering vaginally) or the hour preceding the decision for cesarean were analyzed.

Results Of 224 patients, 167 had evaluable data. The proportion of F dominant contractions was not different for women undergoing cesarean for labor dystocia (n = 11) compared with all others (n = 156)—88.7 ± 10.2 versus 86.0 ± 11.4%; p = 0.44. Results were similar when comparing the cesarean for labor dystocia group to those undergoing cesarean for other indications (n = 10) and vaginal deliveries (n = 146)—88.7 ± 10.2 versus 86.5 ± 10.0 versus 85.9 ± 11.5%; p = 0.74.

Conclusion We were unable to confirm our earlier finding that F dominance of the electrohysterogram is associated with vaginal delivery and lack of F dominance is associated with cesarean for dystocia.

Keywords

labor - labor dystocia - electrohysterography - cesarean delivery - uterine contraction - monitoring
 

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