The Impact of Maternal Body Mass Index and Gestational Age on the Detection of Uterine Contractions by Tocodynamometry

A. Aina-Mumuney, K. Hwang, N. Sunwoo, I. Burd, K. Blakemore

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To examine the impact of maternal body mass index (BMI) and gestational age (GA) on uterine contraction detection by tocodynamometry. Methods: Gravidas with preterm labor (PTL) complaints who were evaluated by tocodynamometry, discharged from Labor and Delivery triage, and subsequently readmitted for preterm delivery were studied. Forty-six patients in whom contractions were detected (group 1) were compared to 49 women in whom contractions were not detected (group 2) with respect to BMI and GA at both evaluation and delivery. Multivariable logistic regression was used to adjust for confounders. Results: Group 2 had a higher mean BMI (31.7 vs 26.1, P <.001), were more likely to be obese (57.1% vs 19.6%, P <.001), and were more likely to have been evaluated in the mid-trimester (36.7% vs 17.4%, P =.04) compared to group 1. Independent risk factors for the inability of the tocodynamometer to detect contractions were obesity (odds ratio [OR] 0.18, 95% confidence interval [CI] 0.07-0.46) and evaluation in the mid-trimester (OR 0.33, 95% CI 0.13-0.84). Conclusion: Our study provides evidence that the effectiveness of tocodynamometry diminishes with increasing maternal BMI. Efficacy of tocodynamometry is also decreased at earlier GA, most pronounced below 25 weeks. To evaluate women with PTL symptoms in the mid-trimester or symptomatic obese women at any GA, a modality other than tocodynamometry could be valuable to more accurately assess uterine activity.

Original languageEnglish (US)
Pages (from-to)638-643
Number of pages6
JournalReproductive Sciences
Volume23
Issue number5
DOIs
StatePublished - May 2016

Keywords

  • body mass index
  • effectiveness of tocodynamometer
  • midtrimester loss
  • preterm labor
  • uterine monitoring

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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