Clinical evaluation of electrohysterography as method of monitoring uterine contractions during labor: A propensity score matched study

Maria W.E. Frenken (Corresponding author), Kirsten M.J. Thijssen, Maria W.C. Vlemminx, Edwin R. van den Heuvel, Michelle E.M.H. Westerhuis, S. Guid Oei

Onderzoeksoutput: Bijdrage aan tijdschriftTijdschriftartikelAcademicpeer review

4 Citaten (Scopus)


OBJECTIVE: Electrohysterography is a non-invasive technique to monitor uterine activity and has a significantly higher sensitivity compared to conventional external tocodynamometry. Whether this technique could lead to improved obstetrical outcomes is still unknown. In this propensity score matched study, clinical results of the first pilot implementing electrohysterography during labor were evaluated. The hypothesis tested is that electrohysterography will help to optimize uterine activity and thereby lead to fewer obstetric interventions. Secondary outcomes were Apgar score, arterial umbilical pH values, first stage labor duration, episiotomy rate and postpartum vaginal blood loss.

STUDY DESIGN: From November 2017 until October 2018, electrohysterography was introduced as a standard alternative for monitoring uterine activity in high-risk deliveries. It could be applied in case of induced labor, previous cesarean delivery, body mass index ≥30 kg/m2 or an inadequate external tocodynamometry monitoring. Outcomes were compared to a matched group of women in which external tocodynamometry was applied for uterine activity monitoring during labor. These women were identified using propensity scores.

RESULTS: A total of 348 women received electrohysterography as standard method of uterine monitoring during labor. A match (1:1 ratio) was found for 317 women, resulting in a total population of 634 women. No significant differences were seen in obstetric interventions (i.e. cesarean deliveries and assisted vaginal deliveries) between the electrohysterography and tocodynamometry group (P = 0.80). No statistically significant differences were seen regarding the secondary outcomes.

CONCLUSIONS: This first pilot study implementing electrohysterography as monitoring method during labor in a high-risk population did not result in statistically significant differences regarding obstetric interventions, low Apgar scores or low umbilical artery pH values. Therefore, we suggest that electrohysterography causes no harm and we recommend further implementation and evaluation in clinical practice.

Originele taal-2Engels
Pagina's (van-tot)178-184
Aantal pagina's7
TijdschriftEuropean Journal of Obstetrics & Gynecology and Reproductive Biology
StatusGepubliceerd - 1 apr. 2021


We would like to thank the Dutch Foundation ‘Stichting de Weijerhorst’ and the Horizon 2020 grant, The European Framework Program for Research and Innovation (Project number 719500) for financial support. The abovementioned sponsors had no involvement in the study design, collection, analysis, writing of the report or decision to submit the article for publication.

European Framework Program for Research and Innovation719500
Horizon 2020


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