Use of Non-invasive Uterine Electromyography in the Diagnosis of Preterm Labour

Keywords:

cervical length, preterm delivery, preterm labour, preterm birth, tocodynamometry, uterine electromyography

M. Lucovnik, Z. Novak-Antolic, R.E. Garfield

St. Joseph’s Hospital and Medical Center, Downtown Campus at TGen, 445 N 5th Street, Phoenix, AZ 85004, USA

Correspondence at: Robert.Garfield@DignityHealth.org

Abstract

Predictive values of methods currently used in the clinics to diagnose preterm labour are low. This leads to missed opportunities to improve neonatal outcomes and, on the other hand, to unnecessary hospitalizations and treatments. In addition, research of new and potentially more effective preterm labour treatments is hindered by the inability to include only patients in true preterm labour into studies. Uterine electromyography (EMG) detects changes in cell excitability and coupling required for labour and has higher predictive values for preterm delivery than currently available methods. This methodology could also provide a better means to evaluate various therapeutic interventions for preterm labour. Our manuscript presents a review of uterine EMG studies examining the potential clinical value that this technology possesses over what is available to physicians currently. We also evaluated the impact that uterine EMG could have on investigation of preterm labour treatments by calculating sample sizes for studies using EMG vs. current methods to enrol women. Besides helping clinicians to make safer and more cost-effective decisions when managing patients with preterm contractions, implementation of uterine EMG for diagnosis of preterm labour would also greatly reduce sample sizes required for studies of treatments.