Monitoring uterine activity and progress of labour using electrohysterography

The rate of obstetric interventions has increased significantly in all western
countries in the past 20 years. The largest increase is found, in absolute
terms, in those pregnancies most likely to deliver vaginally: nullipara at term
with singleton in cephalic presentation. About half of these CS are performed
because of protracted labour. Eventually, because of repeat CS, failure to
progress is thought to account for up to 60% of all CS performed. The diagnosis
of protracted labour or labour arrest, however, is not unequivocally defined. A
more thorough understanding of the (patho)physiology of labour is clearly
required to refine the risk estimation of labour protraction and thus improve
the indication for obstetric interventions. Accurate monitoring of labour could
play a large role in this process. Recently, a new way of measuring uterine
activity based on non-invasive measurement of its electrical activity has been
developed. So far, electrohysterograms (EHG) derived by this method seem to
correlate well with other measures of uterine activity and could to be able to
help predict adequate progression of labour.

Investigate whether characteristics of uterine activity during labour measured
using EHG are associated with the rate of cervical dilatation.

Prospective cohort study.

The EHG recording apparatus is CE approved and presents no risks whatsoever for
mother or child. It is non-invasive, does not prevent the use of any other
diagnostic tools used in current clinical practice and does not restraint the
mobility of women in labour. In preliminary studies, only minor discomfort due
to local irritation under the electrodes has been experienced by participating
women.