title: [Recording expulsive forces during childbirth using intercostal muscle electromyogram: a pilot study].
abstract: OBJECTIVE
  The expulsive forces of childbirth can be included among the many potential risk factors implicated in the subsequent development of perineal disorders. The objective of this study was to devise a non-invasive way to measure abdominal pushing that would accurately represent the expulsive forces during childbirth.
  
  
  METHODS
  By means of intravesical and intrauterine manometry, and electromyography (EMG) of intercostal muscles, we quantified these forces in 21 women during vaginal delivery.
  
  
  RESULTS
  A mixed Ancova model showed the integral of intravesical pressure to be significantly associated (P<0.001) with the integral of intercostal muscle electrical activity during the first 6 uterine contractions during the phase of fetal expulsion.
  
  
  CONCLUSIONS
  Electromyography is a non-invasive measurement that can replace intravesical determinations to quantify these forces as it reflects the real intra-abdominal pressure.
authors.affiliation: Service de gynécologie-obstétrique, hôpital Rothschild, AP-HP, 33, boulevard de Picpus, 75012 Paris, France. fabien.demaria@rth.ap-hop-paris.fr
authors.forename: F
authors.initials: F
authors.lastname: Demaria
authors.forename: R
authors.initials: R
authors.lastname: Porcher
authors.forename: S
authors.initials: S
authors.lastname: Sheik-Ismael
authors.forename: G
authors.initials: G
authors.lastname: Amarenco
authors.forename: J-L
authors.initials: JL
authors.lastname: Benifla
mesh_terms: D000328:Adult; D001034:Apgar Score; D036861:Delivery, Obstetric; D004576:Electromyography; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007743:Labor, Obstetric; D010865:Pilot Projects; D011247:Pregnancy; D011312:Pressure; D014590:Uterine Contraction / Q000502:physiology*