TRANSCUTANEOUS ELECTROMYOGRAPHY OF UTERUS IN PREDICTION OF LABOR OUTCOME INDUCED BY OXYTOCINE AND PROSTAGLANDINE SHAPES
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Sažetak Objective. To establish and evaluate the electromyographic uterine activity during labour induction by oxytocine and local prostaglandines. Material and methods. Myometrium electrical activity during the labor induction was analysed in 95 gravidas hospitalized in Maternity Department of General hospital in Bjelovar. Medium for labor induction at 54 pregnant patients was oxytocine infusion, at 20 intracervical prostaglandine (dinoprostone 0.5 mg) and at 21 intravaginal prostaglandine (dinoprostone 2 mg). Electromyographical measurement has been done after 30, 90, 150 and 270 minutes following application of medium for labor induction. In all pregnancies there was electromyographicaly proved silence of uterus before the starting of induction. Characteristics of electrical bursts were analyzed separately (number of impulses, amplitudes, series, shape) and each record was merged by index of uterine activity according to Škrablin-Kučić formula: uterine activity index= number of impulses during 10 minute period + amplitude (µV) of highest potential divided by 100, by which the series of bursts were marked by aditional 20, biphasic waves with 2 and polyphasic with 3 points. At the pregnant in whom the labor was successfully induced and vaginaly completed the height of amplitudes and the bursts frequency of polyphasic action potentials and salves of AP were analysed. The statistically significant difference in values of EMG IUA was analyzed. Results. Comparing the values of EMG IUA between successful and unsuccessful labor inductions by oxytocin infusion it has been estabilished statistically significant difference (p<0.05) in 30th minute of induction, than it disappears and appears again in the 150-th minute and persist up to the last measurement in the 270th minute. When local prostaglandine ways were used, the statistically significant difference in values of EMG IUA (p<0.05) between successful and unsuccessful labor inductions appears in 210th minute and exists up to the last measurement. Analyzing the height of amplitudes and frequency of polyphasic action potentials and salves of AP in successfully induced and vaginaly accomplished labors, the significantly higher values of amplitude in oxytocin cases in relation to both ways of prostaglandine starting at the 90th minute of induction were established. In the 30th minute of induction there is statistically significant difference between oxytocine and intracervical prostaglandine, and between intracervical and intravaginal shape of prostaglandine (p<0.05). By statistical analysis of frequencies of polyphasic AP and AP salves during successfull labor induction considering the induction method, statistically higher frequencies were proved at induction with prostaglandines in relation to oxytocine, independently of way of application of prostaglandine in measuring after 270 minutes (p<0.05). Conclusion. Registering the action potentials from the skin surface in pregnant patients with specially adapted mechanism and cutaneous electrodes is an uninvasive diagnostic method that is positively correlated to the outcome of induced labor and could be useful in the control of the mechanical activity of myometrium.