Critical analysis of electrohysterographic methods for continuous monitoring of intrauterine pressure

M J Rooijakkers (Corresponding author), C Rabotti, S G Oei, M Mischi

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5 Citations (Scopus)


Monitoring the progression of uterine activity provides important prognostic information during pregnancy and delivery. Currently, uterine activity monitoring relies on direct or indirect mechanical measurements of intrauterine pressure (IUP), which are unsuitable for continuous long-term observation. The electrohysterogram (EHG) provides a non-invasive alternative to the existing methods and is suitable for long-term ambulatory use. Several published state-of-the-art methods for EHG-based IUP estimation are here discussed, analyzed, optimized, and compared. By means of parameter space exploration, key parameters of the methods are evaluated for their relevance and optimal values. We have optimized all methods towards higher IUP estimation accuracy and lower computational complexity. Their accuracy was compared with the gold standard accuracy of internally measured IUP. Their computational complexity was compared based on the required number of multiplications per second (MPS). Significant reductions in computational complexity have been obtained for all published algorithms, while improving IUP estimation accuracy. A correlation coefficient of 0.72 can be obtained using fewer than 120 MPS. We conclude that long-term ambulatory monitoring of uterine activity is possible using EHG-based methods. Furthermore, the choice of a base method for IUP estimation is less important than the correct selection of electrode positions, filter parameters, and postprocessing methods. The presented review of state-of-the-art methods and applied optimizations show that long-term ambulatory IUP monitoring is feasible using EHG measurements.

Original languageEnglish
Pages (from-to)3019-3039
Number of pages21
JournalMathematical Biosciences and Engineering
Issue number4
Publication statusPublished - 1 Apr 2020


This work was supported by the Dutch technology foundation STW and the NWO(TTW) HTSM grant 14663 (EWAM).

FundersFunder number
Nederlandse Organisatie voor Wetenschappelijk Onderzoek14663
Stichting Voor De Technische Wetenschappen


    • Ambulatory
    • Computational complexity
    • Electrohysterography
    • Intrauterine pressure
    • Long-term monitoring
    • Parameter space exploration
    • Pregnancy
    • Uterine activity


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