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The role of cervical Electrical Impedance Spectroscopy in the prediction of the course and outcome of induced labour

BACKGROUND: Previous work by us and others had suggested that cervical electrical impedance spectroscopy (EIS) may be predictive of the outcome of induced labour. We sought to determine which probe configuration of the EIS device is predictive of the outcome of induced labour and compare this to dig...

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Autores principales: Jokhi, Roobin P, Brown, Brian H, Anumba, Dilly OC
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3224746/
https://www.ncbi.nlm.nih.gov/pubmed/19725953
http://dx.doi.org/10.1186/1471-2393-9-40
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author Jokhi, Roobin P
Brown, Brian H
Anumba, Dilly OC
author_facet Jokhi, Roobin P
Brown, Brian H
Anumba, Dilly OC
author_sort Jokhi, Roobin P
collection PubMed
description BACKGROUND: Previous work by us and others had suggested that cervical electrical impedance spectroscopy (EIS) may be predictive of the outcome of induced labour. We sought to determine which probe configuration of the EIS device is predictive of the outcome of induced labour and compare this to digital assessment by the Bishop score. METHODS: In a prospective cohort of 205 women admitted for induction of labour, we used four probes of diameter 3, 6, 9 and 12 mm connected to an impedance meter to measure cervical resistivity (CR) in Ohm.meters at 14 electrical frequencies and compared their values to digital assessment of the cervix by the Bishop score for the prediction of the outcome of induced labour. We tested the association of labour characteristics and outcomes with CR and Bishop score by stepwise multilinear regression analyses, and the accuracy of prediction of categorical clinical outcomes by analysis of the area under the curves (AUC) of derived Receiver Operator Characteristic (ROC) curves. RESULTS: Of the four CR probe dimensions studied, only the 12 mm probe was predictive of any labour indices. In the frequency range 19 - 156 kHz, CR obtained with this probe was higher in women who delivered by caesarean section (CS) than those who delivered vaginally, and in labours lasting > 24 hrs. Cervical resistivity at 78.1 kHz best predicted vaginal delivery [optimal cut-off <2.25 Ohm.meter, AUC 0.66 (95% CI 0.59-0.72), sensitivity 71.0%, specificity 56.5%, LR+ 1.63, LR- 0.51, P < 0.01] and labour duration >24 hrs [optimal cut-off 2.27 Ω.m, AUC 0.65 (95% CI 0.58, 0.72), sensitivity 71%, specificity 59%, LR+ 1.72, LR- 0.50, P < 0.05]. In contrast digital assessment by the Bishop score neither predicted vaginal delivery nor the duration of labour. However, Bishop score predicted time to onset of labour > 12 hours and induction-delivery interval < 24 hrs [optimal cut-off ≤ 4, AUC 0.8 (95% CI 0.75, 0.86), sensitivity 77%, specificity 76%, LR+ 3.3, LR- 0.3, P < 0.05] whilst CR did not. CONCLUSION: Cervical resistivity appears predictive of labour duration and delivery mode following induced labour. However the low predictive values obtained suggest that its current design proffers no immediate clinical utility.
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spelling pubmed-32247462011-11-28 The role of cervical Electrical Impedance Spectroscopy in the prediction of the course and outcome of induced labour Jokhi, Roobin P Brown, Brian H Anumba, Dilly OC BMC Pregnancy Childbirth Research Article BACKGROUND: Previous work by us and others had suggested that cervical electrical impedance spectroscopy (EIS) may be predictive of the outcome of induced labour. We sought to determine which probe configuration of the EIS device is predictive of the outcome of induced labour and compare this to digital assessment by the Bishop score. METHODS: In a prospective cohort of 205 women admitted for induction of labour, we used four probes of diameter 3, 6, 9 and 12 mm connected to an impedance meter to measure cervical resistivity (CR) in Ohm.meters at 14 electrical frequencies and compared their values to digital assessment of the cervix by the Bishop score for the prediction of the outcome of induced labour. We tested the association of labour characteristics and outcomes with CR and Bishop score by stepwise multilinear regression analyses, and the accuracy of prediction of categorical clinical outcomes by analysis of the area under the curves (AUC) of derived Receiver Operator Characteristic (ROC) curves. RESULTS: Of the four CR probe dimensions studied, only the 12 mm probe was predictive of any labour indices. In the frequency range 19 - 156 kHz, CR obtained with this probe was higher in women who delivered by caesarean section (CS) than those who delivered vaginally, and in labours lasting > 24 hrs. Cervical resistivity at 78.1 kHz best predicted vaginal delivery [optimal cut-off <2.25 Ohm.meter, AUC 0.66 (95% CI 0.59-0.72), sensitivity 71.0%, specificity 56.5%, LR+ 1.63, LR- 0.51, P < 0.01] and labour duration >24 hrs [optimal cut-off 2.27 Ω.m, AUC 0.65 (95% CI 0.58, 0.72), sensitivity 71%, specificity 59%, LR+ 1.72, LR- 0.50, P < 0.05]. In contrast digital assessment by the Bishop score neither predicted vaginal delivery nor the duration of labour. However, Bishop score predicted time to onset of labour > 12 hours and induction-delivery interval < 24 hrs [optimal cut-off ≤ 4, AUC 0.8 (95% CI 0.75, 0.86), sensitivity 77%, specificity 76%, LR+ 3.3, LR- 0.3, P < 0.05] whilst CR did not. CONCLUSION: Cervical resistivity appears predictive of labour duration and delivery mode following induced labour. However the low predictive values obtained suggest that its current design proffers no immediate clinical utility. BioMed Central 2009-09-02 /pmc/articles/PMC3224746/ /pubmed/19725953 http://dx.doi.org/10.1186/1471-2393-9-40 Text en Copyright ©2009 Jokhi et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Jokhi, Roobin P
Brown, Brian H
Anumba, Dilly OC
The role of cervical Electrical Impedance Spectroscopy in the prediction of the course and outcome of induced labour
title The role of cervical Electrical Impedance Spectroscopy in the prediction of the course and outcome of induced labour
title_full The role of cervical Electrical Impedance Spectroscopy in the prediction of the course and outcome of induced labour
title_fullStr The role of cervical Electrical Impedance Spectroscopy in the prediction of the course and outcome of induced labour
title_full_unstemmed The role of cervical Electrical Impedance Spectroscopy in the prediction of the course and outcome of induced labour
title_short The role of cervical Electrical Impedance Spectroscopy in the prediction of the course and outcome of induced labour
title_sort role of cervical electrical impedance spectroscopy in the prediction of the course and outcome of induced labour
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3224746/
https://www.ncbi.nlm.nih.gov/pubmed/19725953
http://dx.doi.org/10.1186/1471-2393-9-40
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