Accesso libero

Identification of contractions from Electrohysterography for prediction of prolonged labor

INFORMAZIONI SU QUESTO ARTICOLO

Cita

Fig.1

Representation of surface electrode positioning on the abdominal surface.
Representation of surface electrode positioning on the abdominal surface.

Fig. 2

A comparison of contractions detected using the three methods for the same signal. Top represents the filtering method. Middle represents the statistical method. Bottom represents the TKEO method.
A comparison of contractions detected using the three methods for the same signal. Top represents the filtering method. Middle represents the statistical method. Bottom represents the TKEO method.

Fig. 3

Five equi-temporal regions of a contraction
Five equi-temporal regions of a contraction

Fig. 4

The transition patterns of contractions between the states represented in percentage
The transition patterns of contractions between the states represented in percentage

Fig. 5

Representation of the Markov chain correlation coefficients and the dominance of the uterine segment associated with them.
Representation of the Markov chain correlation coefficients and the dominance of the uterine segment associated with them.

Fig. 6

Confusion matrix of the prediction of the prolonged labor for the test data.
Confusion matrix of the prediction of the prolonged labor for the test data.

Algorithm to define threshold to segment contractions identified from the TKEO method.

Defining threshold to segment contractions from TKEO method
1. Obtain the contraction wave from the EHG signals using the TKEO process.
2. A four-minute window of the RMS signal is chosen.
3. Hanning window function is used to eliminate the edge effects.
4. Set Threshold = 1.2*(basal tone + 25% signal range) where Basal tone = mean of 10% of the lowest values.
5. If the sample value > threshold and is true for > 10 seconds, then
6. It is identified as a contraction
7. Else
8. Move to next sample till the last sample in the four-minute window
9. Slide the four-minute window by one minute & repeat steps 3 to 8

TKEO based algorithm to identify contractions.

TKEO based algorithm to identify contractions
1. The unprocessed EHG signals are obtained.
2. A running mean (an averaging filter) filter is applied to suppress the short-term noise.
3. Linear trends or baseline wandering (if observed) is eliminated by detrending the signal.
4. TKEO and z-score is obtained for the detrended signal.
5. A Gaussian-smoothing filter is applied to smoothen the signal.
6. An envelope of the filtered signal is obtained.
7. Contractions identified.

Transition probabilities of arrested/prolonged progress group

States State 1 State 2 State 3 State 4 State 5
State 1 0.667 0.333 1.000 0.000 0.667
State 2 0.067 0.000 0.000 0.000 0.000
State 3 0.067 0.000 0.000 0.000 0.000
State 4 0.000 0.000 0.000 1.000 0.333
State 5 0.200 0.667 0.000 0.000 0.000

Dominant region of the uterus during contractions.

Feature Group Upper uterine segment Lower uterine segment
Normal progress 38.94% 61.05%
Dominance arrested Prolonged/ progress 73.58% 26.41%

Transition probabilities of normal progress group.

States State 1 State 2 State 3 State 4 State 5
State 1 0.692 0.263 0.400 0.500 0.385
State 2 0.051 0.368 0.200 0.500 0.231
State 3 0.026 0.053 0.200 0.000 0.231
State 4 0.051 0.105 0.000 0.000 0.154
State 5 0.179 0.211 0.200 0.000 0.000

The algorithm to calculate the dominant region of the contraction.

1. Bipolar signals BPU and BPL representing the electrical activity specific to the upper and lower uterine segments are calculated.
2. An envelope of the BPU and BPL is obtained by using Hilbert’s transform.
3. The entire duration of contraction is divided into five equal parts 1 to 5.
4. The RMS amplitude is calculated for the upper and the lower bipolar signals for regions 2,3 and 4 (RMS-u2, RMS-u3, RMS-u4 and RMS-l2, RMS-l3, RMS-l4) representing the most substantial part of the contraction.
5. Dominance is calculated for segments 2, 3 & 4 (D2, D3, D4).
6. The upper uterine segment is dominant if D is positive, and the lower uterine segment is dominant if D is negative.
7. The dominance for the entire contraction is considered to be the most common pattern of dominance in segments 2, 3, and 4.
8. End