Electromyography in Labor and Parturition

Study Overview
=================
Brief Summary
-----------------
This study will examine how the uterus, abdominal wall, pelvic floor and brain interact during labor and parturition. It will uses electromyography (EMG) to compare the characteristics of the uterus, abdominal wall and perineum in subjects with and without various pregnancy characteristics. EMG will help established burst frequency and characteristics of the uterus compared to other parts of the body during labor and delivery. Other parts of the body may include abdominal surfaces (for uterine, abdominal, maternal EMG and fetal heart rate monitoring), perineal surface (for perineal muscles monitoring) and the maternal scalp (brain monitoring). EEG measures the electrical activity of the brain. The activity is recorded using wire electrodes attached to the scalp or mounted on a cap placed on the head. E MG measures electrical activity from muscles. It uses wire electrodes placed on the skin over the muscles. Pregnant adult volunteers and patients who present to the investigator's institution may be eligible for this study. Participants will lay or sit in a semi-reclining chair with sticker electrodes placed on the body surface area of interest. Muscle and/or brain activity will be measured with EEG and EMG recordings.

Detailed Description
-----------------
Objectives To define the relationship between uterine electrical activity EMG during labor and parturition to various phases of labor and cervical dilations. To define the relationship between uterine and body site electrical activity EMG and brain EEG during labor and parturition in patient with hypertensive disorders of pregnancy To characterize electrical activity of pelvic floor muscles in relationship to uterine and abdominal muscles during delivery between subsets of patients To examine the electrical activity of women in preterm labor and those with labor dystocias to observe the effects of various treatments, which may have an impact on preventing or augmenting labor progress. To observe the impact of naturally occurring pregnancy pathology and common obstetrical interventions on the changes in uterine, abdominal, pelvic floor and brain EEG/EMG characteristics as compared to health normal gravid patients. Study Population: Pregnant volunteers greater than 18 years of age who speak English. Design: During the course of the participant's admission, they will be dispositioned to usual obstetric care which may include minimal intervention if spontaneous labor, induction of labor or augmentation of labor as indicated. As part of the study protocol, enrolled participants will be monitored with external sensors/transducers. The device will be attached to a patient's body, which may include the abdominal surface, perineal surface and the mother's scalp by trained study staff through electrical leads that are connected to commercially available EMG or EEG electrodes that have adhesive material in contact with the surface of the patient. Recordings will be made at specific times during labor

Official Title
-----------------
Multichannel Surface Electromyography in Labor and Parturition

Conditions
-----------------
Labor

Intervention / Treatment
-----------------
* Other: Observation


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Pregnant women admitted to the Labor & Delivery unit at Banner University Medical Center - Phoenix for either (a) labor or (b) induction of labor. Age > 18 years-old No contraindications to vaginal delivery Exclusion Criteria: Non-English-speaking patients Known uterine abnormalities that may affect the normal contractility of the uterus.

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
Female

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Primiparous & Multiparous<br>Women having borne at least one child > 20 weeks gestational age | Other: Observation<br>* Patients will be dispositioned to usual obstetric care which may include minimal intervention if spontaneous labor, induction of labor or augmentation of labor as indicated and dictated by the participants obstetrical provider. This study is observational only.<br>|
| Nulliparous<br>Women in whom this is their first pregnancy > 20 weeks who are anticipated to deliver | Other: Observation<br>* Patients will be dispositioned to usual obstetric care which may include minimal intervention if spontaneous labor, induction of labor or augmentation of labor as indicated and dictated by the participants obstetrical provider. This study is observational only.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Burst Characteristic RMS | EEG and EMG burst characteristics will be measured as RMS value (mV). | Through study completion, an average of 3 years | 
| Burst Characteristic Median Frequency | EEG and EMG burst characteristics will be measured as median frequency (Hz). | Through study completion, an average of 3 years | 
| Burst Characteristic Duration | EEG and EMG burst characteristics will be measured as duration (seconds). | Through study completion, an average of 3 years | 
| Burst Characteristics Amplitude | EEG and EMG burst characteristics will be measured as amplitude (mV). | Through study completion, an average of 3 years | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Electroencephalography, Electromyography, Pelvic Floor, Labor curve, Intrauterine infection, Hypertensive Disorders of Pregnancy