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S e p t e m b e r 0 6 - 0 7 , 2 0 1 8 | B a n g k o k , T h a i l a n d
allied
academies
Joint Event on
Global Women Health 2018 & Orthopedics Congress 2018
Archives of General Internal Medicine
|
ISSN: 2591-7951
|
Volume 2
BREAST CANCER, GYNECOLOGY AND WOMEN HEALTH
ORTHOPEDICS AND RHEUMATOLOGY
&
World Congress on
Annual Conference on
Arch Gen Intern Med 2018, Volume 2 | DOI: 10.4066/2591-7951-C3-009
ELECTRICAL INHIBITION (EI) OF PRETERM UTERINE ELECTRICAL AND
MECHANICAL ACTIVITY
Jeffrey Karsdon
1
, Kathryn E Patrick
1
, Frederick Naftolin
2
, Neil Euliano
3
and
Anthony Gregg
1
1
University of Florida, USA
2
New York University Medical Center, USA
3
O B Medical, Gainesville, USA
Introduction:
Uterine smooth muscle electrical activity precedes mechanical contractions and can be monitored with uterine
electromyogram (EMG). A novel localized electrical method is proposed, electrical inhibition (EI), that uses a weak electrical current
as a theorized uterine pacemaker to alter preterm activity of the uterus. The effect of EI on uterine activity can be objectively
monitored using uterine tocodynamometry (TOCO) and EMG. The investigators hypothesis, preterm uterine electrical and
mechanical activity can be inhibited by EI.
Methods:
Patients in preterm labor between 24-34 weeks gestation were identified and consented as per an IRB-approved protocol.
An FDA-approved EI catheter was placed into the vagina adjacent to the posterior cervix under ultrasound guidance. Each patient
underwent a 20-minute pre-EI (C1) period, a 20-minute EI intervention (EI) period, and a 20-minute post-EI control (C2) period. EI
was administered by the FDA-approved EI device. During the EI intervention, a constant bipolar current (0-20 mA at 0-50 Hz) was
manually administered for 10 s with a pulse duration of 0-20 ms at the time of a contraction based on EMG recording. Uterine
EMG was recorded with abdominal surface electrodes. The uterine EMG was computerized to produce the electro-hysterogram
(EHG) and EMG power spectral density (PSD). TOCO and EHG contraction frequency or peak-to-peak (P-P) interval and EMG peak
frequency (Pf) were calculated from the PSD. A paired student t-test was used to analyze differences in P-P and Pf between each
C1, EI, and C2 periods at the 0.05 significance level.
Results:
The average Pf was significantly decreased between CI and EI intervention periods (0.306 vs. 0.221 Hz, p=0.045) as well
as between C1 and C2 periods (0.306 vs. 0.202 Hz, p=0.022). The average P-P interval was significantly increased between C1 and
EI periods (7.1 vs. 11 min, p=0.047). Finally, uterine contraction frequency on TOCO was decreased between C2 and C1 periods (5.5
vs. 8.3 min). There were no adverse events in either mother-neonate dyad related to EI intervention.
Conclusion:
Preterm human uterine electrical and mechanical activity were decreased with EI. Knowledge from this study could
advance the field of preterm birth prevention by supporting the development of an electroceutical tocolytic that obviates the
systemic maternofetal side effects of traditional tocolytics.