Marjan Pajntar

Uterine electrical activity as predictor of preterm birth in women with preterm contractions

OBJECTIVE To estimate the risk of preterm birth in women admitted to the tertiary maternity hospital for preterm contractions by measuring electrical uterine activity. STUDY DESIGN The study included 47 patients with contractions between the 25th and 35th week of gestation and additional risk factors for preterm delivery. Uterine electrical activity was recorded using bipolar electrodes placed on the abdominal surface. A logistic model with the electromyographic and obstetric data was built, preterm delivery before 37th week of gestation being the outcome measure. RESULTS Seventeen patients (36%) delivered before term. Logistic regression model suggested only the intensity of electrical uterine activity and womans body weight to be significant predictors of preterm delivery, with high values related to preterm birth. They predict preterm delivery with the sensitivity of 47% and specificity of 90%. CONCLUSION We propose uterine EMG as a simple, non-invasive means to estimate the risk of preterm birth in a high-risk population with multiple risk factors present.

Activity of smooth muscles in human cervix and uterus.

OBJECTIVE To find the similarities and dissimilarities between the activity of the human smooth muscles in the cervix and in the uterine corpus at the onset of induced labour. STUDY DESIGN Electromyographic activity was measured in 14 primiparous women after amniotomy. The data were sampled and stored digitally in real time. For statistical analysis, the first 20 min of recordings following amniotomy were analyzed. The ratio between the mean activity at a given time and the mean activity over the whole 20 min was used for the comparison between the cervical and uterine activity. RESULTS The analysis of correlation showed that the electromyographic activity in the cervix differed from that in the uterine corpus in the majority of the enrolled cases. CONCLUSIONS The muscular activity in the cervix is independent of that in the uterine corpus at the onset of induced labour.

Active contractions of the cervix in the latent phase of labour

Objective To study the activity of the human uterine cervix at the onset of labour and further characterise cervical asynchronous electromyographic (EMG) activity in the latent phase.

Contribution of cervical smooth muscle activity to the duration of latent and active phases of labour

Objective To identify the effect of cervical muscle activity as an additional factor influencing the duration of the latent and active phase of labour.

A uterine electromyographic activity as a measure of labour progression.

Background:The purpose of this study was the possibility to follow the progress of labour using electromyographic (EMG) signals obtained from the uterine corpus and the cervix. Methods: 28 healty primiparous women with induced labour at an age from 19 to 29 years were enrolled in the study. For interpretation of EMG signals Sample entropy (SampEn), the measure of time series regularity was used. SampEn values were related to the progress of labour recorded in the partogram. h e main outcome is association between labour progress and values of SampEn. Results: Approaching the childbirth during normally progressing labour, regular activity of uterine corpus muscles and cervical muscles is indicated as a decreasing trend in values of SampEn. A delay in the active phase of labour due to active contractions of cervical circular muscles is indicated in greater values of SampEn calculated from cervical EMG activity. Conclusions: By measuring and processing of EMG signals from the uterine corpus and the cervix an obstetrician can obtain an additional useful information on the progress of labour.

Some Neuromuscular Phenomena in Hypnosis

The study of both voluntary and electrically stimulated activity of the neuromuscular system of striated muscles in various conditions of a hypnotic state and under various verbal suggestions in those states of hypnosis, has shown interesting neuromuscular responses in normal test subjects, in patients with various lesions of the peripheral nerves as well as in patients with hemiparesis. An increased EMG response in an electrically stimulated muscle, an increased EMG response and an increased force of the paretic muscle, altered neuromuscular excitability in subjects with lesions of the peripheral nerves (reaction to another type of electrical stimulation), changed fatiguability, altered spasticity, and a corresponding complex mobility at a lower muscle activity have all been observed. It has been noticed that these changes of the neuromuscular system activity often result from a specific state of hypnosis and mostly from specific suggestions and their intensity. Recently we have been studying the effect of hypnosis upon the activity of the smooth muscles, i.e. the bladder and the pregnant uterus before and during labor.

Lightweight application for generating clinical research information systems: MAGIC

Our purpose was to build and test a lightweight solution for generating clinical research information systems (CRIS) that would allow non-IT professionals with basic knowledge of computer usage to quickly define and build a ready-to-use, safe and secure web-based clinical research system for data management. We use the acronym MAGIC (Medical Application Generator InteraCtive) for the system. The generated CRIS should be very easy to build and use, so a common LAMP (Linux Apache MySQL Perl) platform was used, which also enables short development cycles. The application was built and tested using eXtreme Programming (XP) principles by a small development team consisting of one informatics specialist, one physician and one graphical designer/programmer. The parameter and graphical user interface (GUI) definitions for the CRIS can be made by non-IT professionals using an intuitive English-language-like formalism called application definition language (ADL). From these definitions, the MAGIC builds an end-user CRIS that can be used on a wide variety of platforms (from standard workstations to hand-held devices). A working example of a national health-care-quality assessment program is presented to illustrate this process. The lightweight application for generating CRIS (MAGIC) has proven to be useful for both clinical and analytical users in real working environment. To achieve better performance and interoperability, we are planning to recompile the application using XML schemas (XSD) in HL7 CDA or openEHR archetypes formats used for parameters definition and for data interchange between different information systems.SummaryBackgroundOur purpose was to build and test a lightweight solution for generating clinical research information systems (CRIS) that would allow non-IT professionals with basic knowledge of computer usage to quickly define and build a ready-to-use, safe and secure web-based clinical research system for data management. We use the acronym MAGIC (Medical Application Generator InteraCtive) for the system.MethodsThe generated CRIS should be very easy to build and use, so a common LAMP (Linux Apache MySQL Perl) platform was used, which also enables short development cycles. The application was built and tested using eXtreme Programming (XP) principles by a small development team consisting of one informatics specialist, one physician and one graphical designer/programmer.ResultsThe parameter and graphical user interface (GUI) definitions for the CRIS can be made by non-IT professionals using an intuitive English-language-like formalism called application definition language (ADL). From these definitions, the MAGIC builds an end-user CRIS that can be used on a wide variety of platforms (from standard workstations to hand-held devices). A working example of a national health-care-quality assessment program is presented to illustrate this process.ConclusionThe lightweight application for generating CRIS (MAGIC) has proven to be useful for both clinical and analytical users in real working environment. To achieve better performance and interoperability, we are planning to recompile the application using XML schemas (XSD) in HL7 CDA or openEHR archetypes formats used for parameters definition and for data interchange between different information systems.