A joint team of Valencia’s Polytechnic University (UPV) and the city’s Hospital Universitari i Politècnic La Fe has developed a new technique that would help predict the success of labour induction during the first hours during which it is applied. Its progress has been recognised with the Jack Perkins Prize, which annually recognises the best work published in the Medical Engineering & Physics journal.
Labour induction is a common obstetric procedure and is conducted in an increasing number of cases. It can last many hours, specifically between 17 and more than 36 in some cases. Furthermore, it is a practice that does not guarantee a vaginal delivery. In fact, almost 20% of all labour inductions end with caesarean deliveries.
“Predicting the success of the induction is a key aspect to improve the well-being of the mother and the foetus, and also to decrease medical attention costs,” explains Gema Prats Boluda, from the Centre for Research and Innovation in Bioengineering (CI2B) of the UPV.
Currently, as explained by Carlos Benalcázar, a fellow member of the CI2B of the UPV, the most common method for predicting its success is based on evaluating the cervix with the Bishop score, although this method is subjective and not very reliable.
The proposal of the UPV and Hospital La Fe team consists of monitoring uterine activity for the first four hours of the induction process, with the technique they have developed. Thanks to this technique, it is possible to register the bioelectric activity of the muscle (similarly as with electrocardiography), by placing adhesive patches (electrodes) on the mother’s abdomen.
“The characteristics of said activity have made it possible, on one hand, to observe the differences in the response to the two most commonly used types of medicines used for labour induction. And we saw that misoprostol generates a quicker response than dinoprostone. On the other hand, it was observed that women whose induction was successful showed a significantly different response to the drug compared to others whose process ended hours later with a caesarean delivery,” explains Yiyao Ye Lin, from the CI2B of the UPV.
Based on this technique, the team of the UPV and Hospital La Fe have developed an automated system to help diagnose the induction’s success, with success rates greater than 90%, improving the rates of classic obstetric indicators which are around 75%.
“All this can be of great significance in taking labour management decisions, and would help obstetrics specialists prevent or decrease unnecessarily long inductions, decrease the mother-foetus risk and suffering, and decrease hospitalisation costs,” highlights doctor Alfredo Perales, head of the Women’s Clinical Department and of the Gynaecology Department of the Hospital La Fe.
The research team is comprised by the CI2B of the UPV, the Obstetrics Department of the Hospital La Fe and the Unit of Bioelectronics R&D, Signal Processing and Algorithmics of the IIS La Fe. The team is making significative strides in other relevant obstetric situations, such as predicting premature births, post-partum haemorrhage, dystocia or improving the mother-foetus monitoring systems.
“These results show the synergy obtained from the joint work of the clinic staff with personnel that has a more technical profile, and reveal how the actions that intend on promoting this collaboration lead to an improvement of the healthcare system and benefits for the patients,” says Javier García Casado, from the CI2B of the UPV.
On the Jack Perkins Prize
The Jack Perkins Prize is awarded every year to the best article published in the Medical Enginering & Physics journal, based on the assessment of its editorial committee comprised by experts in medicine, engineering and physics applied to research and development in biomedical and health engineering. It is a journal with great international prestige that publishes works of high relevance for the application of the basic principles of physics and engineering to the development of medical and technological devices, with the end goal of producing improvements in the quality of medical attention.
- Benalcazar Parra, Carlos; Ye Lin, Yiyao; Garcia-Casado, Javier; Monfort-Orti, Rogelio; Alberola-Rubio, Jose; Perales, Alfredo; Prats-Boluda, Gema. Electrohysterographic characterization of the uterine myoelectrical response to labor induction drugs. Medical Engineering & Physics. DOI: 10.1016/j.medengphy.2018.04.002
- Carlos Benalcazar-Parra, Yiyao Ye-Lin, Javier Garcia-Casado, Rogelio Monfort-Ortiz, Jose Alberola-Rubio, Alfredo Perales, and Gema Prats-Boluda. Prediction of Labor Induction Success from the Uterine Electrohysterogram. Journal of sensors. DOI: 10.1155/2019/6916251