Use of uterine electromyography in the prediction of preterm birth after transvaginal cervical cerclage
Abstract Background Preterm birth (PTB), complications of which account for approximately 35% of deaths among neonates, remains a crucial issue. Cervical insufficiency (CI) is defined as the inability of the utrine cervix to retain a pregnancy, leading to PTB. Cervical cerclage is an efficient surge...
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BMC
2024-10-01
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| Series: | BMC Pregnancy and Childbirth |
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| Online Access: | https://doi.org/10.1186/s12884-024-06779-3 |
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| author | Haitian Xie Menglan Zhu Kewen Deng Jinling Yi Liqiong Zhu Jianping Tan Xiaohui Ji Phei Er Saw Chunwei Cao Nengyong Ouyang Hui Chen |
| author_facet | Haitian Xie Menglan Zhu Kewen Deng Jinling Yi Liqiong Zhu Jianping Tan Xiaohui Ji Phei Er Saw Chunwei Cao Nengyong Ouyang Hui Chen |
| author_sort | Haitian Xie |
| collection | DOAJ |
| description | Abstract Background Preterm birth (PTB), complications of which account for approximately 35% of deaths among neonates, remains a crucial issue. Cervical insufficiency (CI) is defined as the inability of the utrine cervix to retain a pregnancy, leading to PTB. Cervical cerclage is an efficient surgery for CI patients by preventing the cervix from being further mechanically shortened. Unfortunately, a certain number of patients who had cerclage still delivered prematurely, raising the urgent need to accurately assess the risk of PTB in patients with cerclage. Uterine electromyography (uEMG) is an emerging technology that characterizes uterine contractions by describing the actual evolution process of uterine activity and has been used to predict PTB in recent years. Method In this single-center retrospective case-control study, singleton pregnancy women who received cervical cerclage and uEMG assessment between January 2018 and January 2022 at the Sun Yat-sen Memorial Hospital of Sun Yat-sen University were enrolled. Results 32 PTBs were observed of the 69 women who underwent assessment. Based on multivariate logistic regression analysis, PTB after cerclage was significantly associated with previous PTB history or mid-trimester pregnancy loss (OR: 2.87, 95%CI: 1.49–5.54) and contraction frequency detected by uEMG (OR: 2.24, 95%CI: 1.44–3.49). The AUC of contraction frequency (0.766, P<0.001) was observed, and the optimal cut-off value suggested by Youden Index was 1.75 times per hour. Combined with previous preterm history and cervical length, the AUC of contraction frequency reached 0.858. After stratification by contraction frequency, the median duration was 11 weeks in the high frequency group (> 1.75 times per hour) and 15 weeks in the low frequency group (≤ 1.75 times per hour) (P<0.001). Conclusions The uEMG effectively predicts PTB after transvaginal cervical cerclage and provides a new method for clinicians to evaluate the pregnancy outcome of CI patients. |
| format | Article |
| id | doaj-art-eb18e5cb55a142a4855321e8b61437d1 |
| institution | OA Journals |
| issn | 1471-2393 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | BMC |
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| series | BMC Pregnancy and Childbirth |
| spelling | doaj-art-eb18e5cb55a142a4855321e8b61437d12025-08-20T02:18:28ZengBMCBMC Pregnancy and Childbirth1471-23932024-10-0124111010.1186/s12884-024-06779-3Use of uterine electromyography in the prediction of preterm birth after transvaginal cervical cerclageHaitian Xie0Menglan Zhu1Kewen Deng2Jinling Yi3Liqiong Zhu4Jianping Tan5Xiaohui Ji6Phei Er Saw7Chunwei Cao8Nengyong Ouyang9Hui Chen10Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen UniversityDepartment of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen UniversityDepartment of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen UniversityFifth Affiliated Hospital of Xinjiang Medical UniversityDepartment of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen UniversityDepartment of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen UniversityDepartment of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen UniversityDepartment of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen UniversityDepartment of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen UniversityDepartment of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen UniversityDepartment of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen UniversityAbstract Background Preterm birth (PTB), complications of which account for approximately 35% of deaths among neonates, remains a crucial issue. Cervical insufficiency (CI) is defined as the inability of the utrine cervix to retain a pregnancy, leading to PTB. Cervical cerclage is an efficient surgery for CI patients by preventing the cervix from being further mechanically shortened. Unfortunately, a certain number of patients who had cerclage still delivered prematurely, raising the urgent need to accurately assess the risk of PTB in patients with cerclage. Uterine electromyography (uEMG) is an emerging technology that characterizes uterine contractions by describing the actual evolution process of uterine activity and has been used to predict PTB in recent years. Method In this single-center retrospective case-control study, singleton pregnancy women who received cervical cerclage and uEMG assessment between January 2018 and January 2022 at the Sun Yat-sen Memorial Hospital of Sun Yat-sen University were enrolled. Results 32 PTBs were observed of the 69 women who underwent assessment. Based on multivariate logistic regression analysis, PTB after cerclage was significantly associated with previous PTB history or mid-trimester pregnancy loss (OR: 2.87, 95%CI: 1.49–5.54) and contraction frequency detected by uEMG (OR: 2.24, 95%CI: 1.44–3.49). The AUC of contraction frequency (0.766, P<0.001) was observed, and the optimal cut-off value suggested by Youden Index was 1.75 times per hour. Combined with previous preterm history and cervical length, the AUC of contraction frequency reached 0.858. After stratification by contraction frequency, the median duration was 11 weeks in the high frequency group (> 1.75 times per hour) and 15 weeks in the low frequency group (≤ 1.75 times per hour) (P<0.001). Conclusions The uEMG effectively predicts PTB after transvaginal cervical cerclage and provides a new method for clinicians to evaluate the pregnancy outcome of CI patients.https://doi.org/10.1186/s12884-024-06779-3Uterine electromyographyCervical cerclageSpontaneous preterm birth |
| spellingShingle | Haitian Xie Menglan Zhu Kewen Deng Jinling Yi Liqiong Zhu Jianping Tan Xiaohui Ji Phei Er Saw Chunwei Cao Nengyong Ouyang Hui Chen Use of uterine electromyography in the prediction of preterm birth after transvaginal cervical cerclage BMC Pregnancy and Childbirth Uterine electromyography Cervical cerclage Spontaneous preterm birth |
| title | Use of uterine electromyography in the prediction of preterm birth after transvaginal cervical cerclage |
| title_full | Use of uterine electromyography in the prediction of preterm birth after transvaginal cervical cerclage |
| title_fullStr | Use of uterine electromyography in the prediction of preterm birth after transvaginal cervical cerclage |
| title_full_unstemmed | Use of uterine electromyography in the prediction of preterm birth after transvaginal cervical cerclage |
| title_short | Use of uterine electromyography in the prediction of preterm birth after transvaginal cervical cerclage |
| title_sort | use of uterine electromyography in the prediction of preterm birth after transvaginal cervical cerclage |
| topic | Uterine electromyography Cervical cerclage Spontaneous preterm birth |
| url | https://doi.org/10.1186/s12884-024-06779-3 |
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