electromyometrial-imaging-of-uterine-contractions-in-pregnant-women

Electromyometrial Imaging of Uterine Contractions in Pregnant Women

During normal pregnancy, the uterine smooth muscle, the myometrium, begins to have weak, uncoordinated contractions at late gestation to help the cervix ...

University of Texas at Austin, Dell Medical School

Investigate marked variability in fetal heart rate (FHR) patterns before delivery and its association with neonatal morbidity and abnormal arterial cord gases.

Marked variability in intrapartum electronic fetal heart rate patterns: association with neonatal morbidity and abnormal arterial cord gas.

Clinically, uterine contractions are monitored with tocodynamometers or intrauterine pressure catheters. In the research setting, electromyography (EMG), which detects electrical activity of the uterus from a few electrodes on the abdomen, is feasible, can provide more accurate data than these other methods, and may be useful for predicting preterm birth. However, EMG lacks sufficient spatial resolution and coverage to reveal where uterine contractions originate, how they propagate, and whether preterm contractions differ between women who do and do not progress to preterm delivery. To address those limitations, electromyometrial imaging (EMMI) was recently developed and validated to non-invasively assess three-dimensional (3D) electrical activation patterns on the entire uterine surface in pregnant sheep. EMMI uses magnetic resonance imaging to obtain subject-specific body-uterus geometry and collects uterine EMG data from up to 256 electrodes on the body surface. EMMI software then solves an ill-posed inverse computation to combine the two datasets and generate maps of electrical activity on the entire 3D uterine surface. Here, we assessed the feasibility to clinically translate EMMI by evaluating EMMI's accuracy under the unavoidable geometrical alterations and electrical noise contamination in a clinical environment. We developed a hybrid experimental-simulation platform to model the effects of fetal kicks, contractions, fetal/maternal movements, and noise contamination caused by maternal respiration and environmental electrical activity. Our data indicate that EMMI can accurately image uterine electrical activity in the presence of geometrical deformations and electrical noise, suggesting that EMMI can be reliably translated to non-invasively image 3D uterine electrical activation in pregnant women.

Accuracy of electromyometrial imaging of uterine contractions in clinical environment.

 Idiopathic polyhydramnios is among the most common etiologies of polyhydramnios. However, conflicting evidence exists regarding the relationship between polyhydramnios and neonatal morbidity. We investigated the association between pregnancies with and without idiopathic polyhydramnios and neonatal morbidity at term.

Idiopathic Polyhydramnios and Neonatal Morbidity at Term.

 To assess depression, anxiety, and burnout among health care workers using well-established validated scales and to examine associations of these mental health outcomes with personal protective equipment (PPE) and high-risk patient contact.  This prospective survey was conducted between August and October 2020 among 970 essential health care workers from 2 health systems in central Texas. The survey captured basic demographic, occupational, and baseline health information including history of mental health disorders. Depression, anxiety, and burnout were assessed with the 8-item Patient Health Questionnaire, 7-item Generalized Anxiety Disorder Scale, and 23-item Burnout Assessment Tool. Questions about clinical contact with patients with suspected or known COVID-19 were also incorporated.  Approximately 24% of respondents had moderate or severe anxiety, 14% had moderate or severe depression, and 7% were at high risk for burnout. Statistically significant associations were found between perceived PPE adequacy and the 3 mental health outcomes, while accounting for age, gender, and education. Hours of contact with COVID-19 patients during aerosolizing procedures was positively correlated with measures of anxiety, burnout, and depression after adjustment for age, gender, and occupational role. Perception of PPE adequacy was inversely correlated with measures of depression, anxiety, and burnout among essential members of 2 health care systems, whose roles precluded working remotely during the pandemic.  This study highlights the correlations of perceptions of PPE adequacy and contact hours with COVID-19 patients undergoing aerosolizing procedures and employee mental well-being. Future work confirming the findings can help identify ways that systems can support their employees through similarly stressful and demanding events.

Occupational Risk Factors and Mental Health Among Frontline Health Care Workers in a Large US Metropolitan Area During the COVID-19 Pandemic.

 To test the hypothesis that elevated umbilical artery (UA) partial pressure of carbon dioxide (pCO) is associated with neonatal morbidity and to compare the risk of neonatal morbidity with different patterns of UA acidosis.

Article	Year
Marked variability in intrapartum electronic fetal heart rate patterns: association with neonatal morbidity and abnormal arterial cord gas. Journal of perinatology : official journal of the California Perinatal Association\| PubMed ID: 31578422	2020
Accuracy of electromyometrial imaging of uterine contractions in clinical environment. Computers in biology and medicine\| PubMed ID: 31786490	2020
Idiopathic Polyhydramnios and Neonatal Morbidity at Term. American journal of perinatology\| PubMed ID: 34775584	2021
Occupational Risk Factors and Mental Health Among Frontline Health Care Workers in a Large US Metropolitan Area During the COVID-19 Pandemic. The primary care companion for CNS disorders\| PubMed ID: 35276759	2022
The Risk of Neonatal Morbidity in Umbilical Artery Hypercarbia and Respiratory Acidosis. American journal of perinatology\| PubMed ID: 36543241	2022

Alison G. Cahill

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