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Noninvasive high-resolution electromyometrial imaging of uterine contractions in a translational sheep model

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Science Translational Medicine  13 Mar 2019:
Vol. 11, Issue 483, eaau1428
DOI: 10.1126/scitranslmed.aau1428

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Reconstructing contractions

Monitoring uterine contractions during labor is critical to ensure good health of the mother and of the baby. Current methods present several limitations, including low resolution and invasiveness. Now, Wu et al. developed a noninvasive three-dimensional electromyometrial imaging called EMMI, able to monitor uterine contractions with high spatial and temporal resolution. Combining data obtained from electrodes placed on the abdomen with magnetic resonance imaging, EMMI reconstructed uterine contraction patterns in sheep. The results matched reconstructions obtained with invasive electrodes placed on the uterine surface. EMMI might provide an easily accessible method to help doctors during labor and to better understand uterine electrophysiology and pathophysiology.


In current clinical practice, uterine contractions are monitored via a tocodynamometer or an intrauterine pressure catheter, both of which provide crude information about contractions. Although electrohysterography/electromyography can measure uterine electrical activity, this method lacks spatial specificity and thus cannot accurately measure the exact location of electrical initiation and location-specific propagation patterns of uterine contractions. To comprehensively evaluate three-dimensional uterine electrical activation patterns, we describe here the development of electromyometrial imaging (EMMI) to display the three-dimensional uterine contractions at high spatial and temporal resolution. EMMI combines detailed body surface electrical recording with body-uterus geometry derived from magnetic resonance images. We used a sheep model to show that EMMI can reconstruct uterine electrical activation patterns from electrodes placed on the abdomen. These patterns closely match those measured with electrodes placed directly on the uterine surface. In addition, modeling experiments showed that EMMI reconstructions are minimally affected by noise and geometrical deformation. Last, we show that EMMI can be used to noninvasively measure uterine contractions in sheep in the same setup as would be used in humans. Our results indicate that EMMI can noninvasively, safely, accurately, robustly, and feasibly image three-dimensional uterine electrical activation during contractions in sheep and suggest that similar results might be obtained in clinical setting.

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