title: Toward a new modality for detecting a uterine rupture: electrohysterogram propagation analysis during trial of labor after cesarean.
abstract: OBJECTIVE
  Observational cohort study which aimed to explore the potential of electrohysterogram (EHG) analysis for detecting a uterine rupture during trial of labor after cesarean. The EHG propagation characteristics surrounding the uterine scar of six patients with a previous cesarean section were compared to a control group of five patients without a scarred uterus.
  
  
  METHODS
  The EHG was recorded during the first stage of labor using a high-resolution 64-channel electrode grid positioned on the maternal abdomen across the cesarean scar. Based on simulations, the inter-channel correlation and propagation direction were adopted as EHG parameters for evaluating possible disruption of electrical propagation by the uterine scar.
  
  
  RESULTS
  No significant differences in inter-channel correlation or propagation direction were observed between the group of patients with an intact uterine scar and the control group. A strong predominance of vertical propagation was observed in one case, in which scar rupture occurred.
  
  
  CONCLUSIONS
  The results support unaffected propagation of electrical activity through the intact uterine scar tissue suggesting that changes in the EHG might only occur in case of rupture.
authors.affiliation: a Department of Obstetrics and Gynecology , Máxima Medical Center , Veldhoven , the Netherlands and.
authors.forename: Hinke
authors.initials: H
authors.lastname: de Lau
authors.affiliation: b Department of Electrical Engineering , University of Technology Eindhoven , Eindhoven , the Netherlands.
authors.forename: Kai Tao
authors.initials: KT
authors.lastname: Yang
authors.affiliation: b Department of Electrical Engineering , University of Technology Eindhoven , Eindhoven , the Netherlands.
authors.forename: Chiara
authors.initials: C
authors.lastname: Rabotti
authors.affiliation: a Department of Obstetrics and Gynecology , Máxima Medical Center , Veldhoven , the Netherlands and.
authors.forename: Marion
authors.initials: M
authors.lastname: Vlemminx
authors.affiliation: b Department of Electrical Engineering , University of Technology Eindhoven , Eindhoven , the Netherlands.
authors.forename: Galin
authors.initials: G
authors.lastname: Bajlekov
authors.affiliation: b Department of Electrical Engineering , University of Technology Eindhoven , Eindhoven , the Netherlands.
authors.forename: Massimo
authors.initials: M
authors.lastname: Mischi
authors.affiliation: a Department of Obstetrics and Gynecology , Máxima Medical Center , Veldhoven , the Netherlands and.
authors.forename: Swan Gie
authors.initials: SG
authors.lastname: Oei
mesh_terms: D000704:Analysis of Variance; D002585:Cesarean Section / Q000009:adverse effects*; D002921:Cicatrix / Q000503:physiopathology; D015331:Cohort Studies; D055724:Electrophysiological Phenomena; D005260:Female; D005323:Fetal Monitoring / Q000379:methods*; D006801:Humans; D007747:Labor Stage, First; D011247:Pregnancy; D014219:Trial of Labor; D014597:Uterine Rupture / Q000175:diagnosis*; D016064:Vaginal Birth after Cesarean / Q000009:adverse effects*
keywords: Electrohysterogram; labor and delivery; trial of labor after cesarean; uterine electromyography; uterine rupture; vaginal birth after cesarean