title: A comparison between electrical uterine monitor, tocodynamometer and intra uterine pressure catheter for uterine activity in labor.
abstract: OBJECTIVE
  We aimed to evaluate the performance of a non-invasive EMG electrical uterine monitor (EUM) versus tocodynamometry (TOCO) by comparing both to internal uterine pressure catheter (IUPC).
  
  
  METHODS
  Prospective observational trial. Uterine activity was recorded continuously and simultaneously, in women during active term labor, with TOCO, EUM and IUPC. Uterine activity tracings were analyzed by three blinded physicians.
  
  
  RESULTS
  Overall, 385 tracings from 43 women were analyzed. A similar rate of interpretable tracings between physicians was demonstrated for EUM (87%; 95% CI 80.9-92.7%) and IUPC (94.8%; 95% CI 83.4-96.3%), with a significantly lower rate for TOCO (67.5%; 95% CI 59.4-76.8%, p < 0.001). There is a significant difference in the contraction frequency for EUM versus IUPC (0.77 ± 2.3) compared to TOCO versus IUPC (-3.34 ± 4.97). There is a high variability between the timing of TOCO contractions as compared to IUPC (4.74 ± 10.03 seconds), while a gap of 8.46 ± 4.24 seconds was detected for EUM. The sensitivity, positive predictive value and false positive rate for individual contraction identification by TOCO and EUM are 54.0%, 84.4%, 15.6% and 94.2%, 87.6%, 12.4%, respectively.
  
  
  CONCLUSIONS
  EUM is efficient as IUPC for uterine activity assessment and both techniques are superior in comparison to external tocodynamometry. Our results support the use of non-invasive EMG technology to monitor uterine activity.
authors.affiliation: a Helen Schneider Hospital for Women, Rabin Medical Center , Petach Tikva , Israel .
authors.forename: Eran
authors.initials: E
authors.lastname: Hadar
authors.forename: Tal
authors.initials: T
authors.lastname: Biron-Shental
authors.forename: Oz
authors.initials: O
authors.lastname: Gavish
authors.forename: Oded
authors.initials: O
authors.lastname: Raban
authors.forename: Yariv
authors.initials: Y
authors.lastname: Yogev
mesh_terms: D000328:Adult; D057785:Catheters; D004576:Electromyography / Q000379:methods*; D005189:False Positive Reactions; D005260:Female; D005865:Gestational Age; D006801:Humans; D007743:Labor, Obstetric / Q000502:physiology*; D008365:Manometry / Q000379:methods; D011247:Pregnancy; D011446:Prospective Studies; D015203:Reproducibility of Results; D014590:Uterine Contraction / Q000523:psychology; D018590:Uterine Monitoring / Q000379:methods*; D014599:Uterus / Q000502:physiology*
keywords: Contractions; EMG; electrical uterine monitor; internal uterine pressure catheter; labor; tocodynamometer