EP0000504A1 - Circuit arrangement for the detection and recording of the activity of the uterus - Google Patents

Circuit arrangement for the detection and recording of the activity of the uterus Download PDF

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Publication number
EP0000504A1
EP0000504A1 EP78100372A EP78100372A EP0000504A1 EP 0000504 A1 EP0000504 A1 EP 0000504A1 EP 78100372 A EP78100372 A EP 78100372A EP 78100372 A EP78100372 A EP 78100372A EP 0000504 A1 EP0000504 A1 EP 0000504A1
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Prior art keywords
signals
signal
essentially
derived
detection
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EP78100372A
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German (de)
French (fr)
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EP0000504B1 (en
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Joachim Nagel
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Biotronik SE and Co KG
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Biotronik Mess und Therapiegeraete GmbH and Co
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/43—Detecting, measuring or recording for evaluating the reproductive systems
    • A61B5/4306—Detecting, measuring or recording for evaluating the reproductive systems for evaluating the female reproductive systems, e.g. gynaecological evaluations
    • A61B5/4343—Pregnancy and labour monitoring, e.g. for labour onset detection
    • A61B5/4362—Assessing foetal parameters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A61B5/344—Foetal cardiography
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/389—Electromyography [EMG]
    • A61B5/391—Electromyography [EMG] of genito-urinary organs

Definitions

  • the invention relates to a device for detecting a registration of uterine activity by means of electrical signals.
  • the monitoring and evaluation of uterine activity which enables an assessment of labor, is important in perinatal medicine to observe the course of pregnancy and to assess the condition of the fetus.
  • a so-called "open-end catheter filled with liquid” is inserted into the amniotic cavity or between the amniotic sac and the wall of the uterus to determine the pressure. After performing a zero adjustment, the absolute pressure of the uterus can be determined using this method.
  • Tokography is based on a method that Rech had specified in 1934.
  • a pressure transducer which is usually designed as a strain gauge, is attached to the abdomen of the pregnant woman with an elastic belt. Due to the stroke changes caused by uterine contractions of a stylus, which acts mechanically on the strain gauge, an electrical signal is obtained which represents a measure of the labor activity and whose temporal course is evaluated by the general practitioner.
  • the method of external tokenography has the disadvantage that the indirect method of taking up pressure is exposed to numerous interferences which falsify the measurement result. Such disturbances already represent, for example, the changes in stroke associated with breathing.
  • the non-invasive procedure is based on the assumption that the pressure detected and registered on the abdomen by means of the stylus represents a sufficient approximation of the intra-uterine pressure. With this measurement, however, it is not possible to obtain sufficiently precise information about the development of the uterine activity.
  • a device for monitoring obstetrics in which the phases of contraction and slackening of the uterus are determined electrically by applying an alternating current of constant strength to the abdomen of the gaggers that the generated signal is collected and demodulated so that the resulting signal is registered and compared with the registered curve of a reference characteristic.
  • the disadvantage of this device is that with the help of the applied alternating current only a little information about labor excitation and spread is obtained. Furthermore. there is a risk that the alternating current has a harmful effect on the fetus.
  • the invention has for its object to provide a device for detection and registration of uterine activity, which is free from the aforementioned disadvantages and enables a patient method that is not a nuisance, which the attending physician routinely performs using a compact device without affecting the course of the birth can.
  • the doctor should be able to evaluate the measurement results in a relatively short time and without any special effort and lead to a reliable diagnosis.
  • the device according to the invention is characterized by means for electromyographic detection of the electrical fields associated with muscle activity in the abdominal area as electrical signals, means for generating the signals which essentially correspond to the intensity of the AC voltage component of the electromyographically derived signal, and means for outputting the averaged signal as a measure of the intrauterine pressure.
  • the invention is based on the knowledge that the intrauterine pressure changes are caused directly by muscle contractions.
  • the electrical fields associated with these contractions can be measured electromyographically on the surface of the skin.
  • a measure of the intensity of the contractions is not directly the measured voltage curve, but, as was found with the invention, an average of the pulsed AC voltage components of the measured signals.
  • Intensity is understood to mean a value that is representative of the magnitude of the amplitude of the AC voltage component and, for example, by rectifying the AC voltage component. or squaring can be obtained in the sense of a performance assessment.
  • the output signal is thus essentially at least similar to an envelope of the electro-myographically detected signal.
  • the maternal and fetal heart signals are contained in the abdominally derived electromyogram as interference signals, but these can, if necessary, be filtered out and evaluated separately.
  • the measurement. information contained and thus accessible to the doctor are more extensive than is the case when using pressure transducers. Since the attachment of skin electrodes is much easier to carry out than the attachment of mechanical pressure transducers, the determination of uterine activity is made considerably easier for the doctor. The reduction in the examination time to be spent per patient is also associated with a reduction in treatment costs.
  • Contractions can be used to draw conclusions about arousal and of contractions. That way it can also early motility disorders, . for example incoordination, recogniz.
  • the evaluation of the myo signals can be carried out in an advantageous manner by using an appropriate bandpass filter in a frequency range of approximately 150 to 250 Hz. It is favorable that the signal components of fetal, which are interfering with the detection of uterine motility. and maternal electrocardiogram in this frequency range. are smaller in amplitude than the myopotentials to be evaluated and therefore have little influence on the result.
  • Another way of reducing the effect of interfering signals on the determination of uterine activity is to make the time constant used for averaging (by low-pass filtering) the rectified or squared signal sufficiently large. In this case, even that frequency range of the myographically recorded signal of approximately 15 to 40 Hz can be used (with a time constant of several seconds). where the heart signals have their maximum.
  • the selection of the narrower frequency range to be evaluated and its width within a total range of approximately 10 to 300 Hz depends on whether the static or dynamic parts of the muscle contract ions should be given out and to what extent the influence of the abdominal muscles (tension in the case of presses) - should appear in the result
  • the output of the averaged signals, which form a measure of the intrauterine pressure, can advantageously
  • the signal processing can be carried out in a particularly simple manner by means of analog modules such as operational amplifiers. If the device according to the invention is combined with one for determining cardiac activity, the signal processing is advantageously carried out digitally, preferably by means of microprocessors.
  • the device according to the invention exhibits its particular advantages in the case that signals affecting both the uterus and the fetal (or maternal) cardiac activity are derived simultaneously by means of electrodes attached to the abdomen, or the recorded signals are evaluated in a common device. This means that there is the option of performing one-on-one examinations with a single patient that is not very stressful Measurement to gain extensive data enable you to quickly get an accurate den: Condition of the fetus and the patient so that he takes the necessary action
  • the frequency range to be evaluated is selected by selecting a correspondingly large time constant for the averaging so that it includes the range of the frequencies taken up by the heart signals, no further filtering means are required to filter the signals for the Detect uterine activity from those for determining heart activity.
  • Fig. 1 is a representation of the signal acquisition give again.
  • Various electrodes 301, 302 and 303 are attached to the measurement value on the body of a patient 304 whose contraction is to be recorded.
  • the heart activity of a fetus 305 is examined at the same time.
  • electromyographically recorded signal course 306 the signal from the heart 307 de fetus is superimposed by the signal from the heart 308 of the mother and various interference components.
  • the fetal or the maternal heart signal is repeatedly identified with mi "f" or "m” in the signal curve 306.
  • the signals representing labor are not directly recognizable in the recorded signal and can only be represented as a curve by the device according to the invention.
  • the first embodiment of the device according to the invention shown in FIG. 2 enables the determination and recording of uterine activity by the detection and evaluation of muscle contractions in the abdominal area.
  • the input of an amplifier 1, which is shown in detail in FIG. 3, is connected via its inputs 2 to the electrodes (not shown here).
  • the signal from the output 7 of the amplifier 1 is fed to an output 8 of a processing part 3, by means of which the signal components relating to uterine activity are processed in such a way that the signal supplied to output 4 of the processing part 3 represents a measure of the uterine motility.
  • output 4 is a.
  • Connected recording device not shown, which records the course of the intensity of the contractions as a function of time, so that the doctor can draw conclusions about the contractions from the resulting characteristic curves, possibly by comparing them with curves listed in a directory.
  • the circuit of the processing part 3 is shown in detail in FIG. 4.
  • the 1 is branched off to a processing part 5 for the heart signals.
  • the output 6 of the processing part 5 provides the fetal electrocardiogram or a signal as a measure of the heart rate and can be reproduced, for example, in its time-dependent curve profile.
  • the representation of the fetal heart signals can be summarized with those of uterine activity in a cardiotocogram, which can be displayed by a single graphic device.
  • FIG. 3 is the complete one for the abdominal signal (1 in Fig. 2) Via the entrance 2 the nal electrodes to one Isolation of patient and measuring device is used.
  • the outputs of the isolation amplifier T 1 are connected to the inputs of a differential amplifier, which consists of an operational amplifier OP 1, which is connected to a number of resistors and capacitors.
  • the resistors R 1 and R 3 or R 2 and R 4 form the capacitors C 2 and C 3 each have an input low-pass filter, while the resistance-capacitor combinations C 1 / R 5 and C 4 / R 6 as well as the capacitor C 5 provide a gain drop to high frequencies, the subsequent stage, which the Operational amplifier OF is in the usual way as switched, the values of the resistors R 7 to R 10 and those of the illustrated embodiment .
  • C 6 to C 9 are selected so that the preferably cut the low frequencies of the abdominal signal.
  • the last stage containing an operational amplifier OP 3 works as a pure AC-coupled amplifier circuit, the is determined by the ratio of the resistors R 11 and R 13 and a garbage comparison of the output signal can be carried out via the resistor R 12 by means of a variable resistor R 15.
  • the overall circuit of the amplifier for the abdominal signal brings about a first trimming of the frequencies interfering in the subsequent signal processing.
  • FIG. 4 shows the circuit of the processing part for the electromyogram (3 in FIG. 2).
  • the circuitry of the operational amplifiers OP 4 and OP 5 with resistors R 16 to R 26 and capacitors C 12 to.
  • the function of C 15 corresponds to that of the operational amplifier OP 2 in FIG. 3.
  • the dimensioning of the values of the components is evident from the attached parts list. It takes place according to the rules valid for deramge active filter circuits.
  • the output level and the quality of the filter can be set by means of the variable resistor R 24.
  • the signal freed from disturbing components in this way serves as an input signal for a signal processing part 3 'in which the signals relating to uterine activity are carried out, as described with reference to processing part 3.
  • the band filter assembly is omitted in the processing part 3 ', since the filtering is carried out jointly by the filter 203.
  • a logarithmic or potentiating distortion of the output amplitude values can take place in an evaluation part 209 can be represented graphically as a function of time using a contraction wrench 210.
  • the mean value of the fetal ECG (QRS complex) is recorded in step 207, while in step 208 the fetal heart rate is calculated and recorded from the time interval between the fetal heart signals.

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Abstract

Vorrichtung zur Detektion und Registrierung der Uterusaktivität mittels elektrischer Signale, insbesondere zur Verwendung als Wehenschreiber, mit Mitteln zur elektromyographischen Erfassung der mit Muskelaktivitäten einhergehenden elektrischen Felder im abdominalen Bereich (Elektroden 301 bis 303) als elektrische Signale, Mitteln zur Erzeugung von Signalen, die im wesentlichan der Intensität der Wechselspannungsanteile der elektromyographisch abgeleiteten Signale entsprechen (OP 6, OP 7), Mitteln zur zeitlichen Mittelung (C 16, R 31) der Signale, die im wesentlichen der Intensität des Wechselspannungsanteils der elektromyographisch abgeleiteten Signale entsprechen, sowie Mitteln zur Ausgabe des gemittelten Signals als Maß für den intrauterinen Druck (Wehenschreiber 210).Device for the detection and registration of uterine activity by means of electrical signals, in particular for use as a labor recorder, with means for the electromyographic detection of the electrical fields associated with muscle activity in the abdominal area (electrodes 301 to 303) as electrical signals, means for generating signals which are essentially relevant correspond to the intensity of the AC voltage components of the electromyographically derived signals (OP 6, OP 7), means for time averaging (C 16, R 31) of the signals which essentially correspond to the intensity of the AC voltage component of the electromyographically derived signals, and means for outputting the averaged Signals as a measure of intrauterine pressure (contractions 210).

Description

Die Erfindung betrifft eine Vorrichtung zur Detektion a Registrierung der Uterusakt ivität mittels elektrischer Signale.The invention relates to a device for detecting a registration of uterine activity by means of electrical signals.

Die Überwachung und Auswertung der Uterusakt ivität, welch eine Beurteilung der Wehentätigkeit ermöglicht, ist in der perinatalen Medizin wichtig zur Beobachtung des Verlaufs der Schwangerschaft und zur Beurteilung des Zustands des Feten.The monitoring and evaluation of uterine activity, which enables an assessment of labor, is important in perinatal medicine to observe the course of pregnancy and to assess the condition of the fetus.

Zur Ermittlung und Aufzeichnung des intrauterinen Drucks in Form des Tokogramms sind bisher im wesentlichen zwei Verfahren, nämlich ein internes und ein externes Verfahren, benutzt worden. Beiden Verfahren ist gemeinsam, daß der uterine Druck mittels Druckaufnehmern am Körpen gemessen wird.To date, two methods, namely an internal and an external method, have been used to determine and record the intrauterine pressure in the form of the tocogram. Both methods have in common that the uterine pressure is measured by means of pressure sensors on the body.

Bei der internen Tokographie wird zur Druckbestimmung ein mit Flüssigkeit gefüllter sogenannter "Open-End-Katheter in die Amnionhöhle oder zwischen Fruchtblase und Uteruswand eingeführt. Nachdem ein Nullabgleich durchgeführt wurde, läßt sich mit diesem Verfahren der absolute Druck des Uterus bestimmen.In internal tokenography, a so-called "open-end catheter filled with liquid" is inserted into the amniotic cavity or between the amniotic sac and the wall of the uterus to determine the pressure. After performing a zero adjustment, the absolute pressure of the uterus can be determined using this method.

Das Verlahren der internen Tokographie wird wegen der schwieriden und nicht risikofreien Handhabung von yielen Ärzten abgelehnt. Darüber hinaus beweisen die jüngst en Untersuchungen eine Beeinflussung des Geburt svorgangs -durch die Applikation des Katheters, weswegen dieses Verfahren gerade bei drohenden Frühgeburten, bei denen eine Uberwachung der Wehentät igke it von besonderer Bedeutung ist, nicht angewandt werden sollte.Many doctors have refused to disclose the internal token because of the difficult and risk-free handling. In addition, the most recent examinations have shown that the birth process is influenced by the application of the catheter, which is why this method should not be used in the case of impending premature births, where monitoring of labor is particularly important.

Die externe. Tokographie beruht auf einem von Rech schon Jahre 1934 angegebenen Verfahren. Ein Druckaufnehmer, der normaler weise als Dehnungsmeßstreifen ausgebildet ist, wird mit einem elastischen Gurt auf dem Abdomen der Schwangeren befestigt. Durch die infolge Uteruskontraktionen verursachten Hubänderungen eines Taststiftes, der mechanisch auf den Dehnungsmeßstreifen wirkt, wird ein elektrisches Signal gewonnen, das ein Maß für die Wehentätigkeit darstellt und in seinem zeitlichen VerLauf von dem berardalnden Arzt ausgewertet wird.The external. Tokography is based on a method that Rech had specified in 1934. A pressure transducer, which is usually designed as a strain gauge, is attached to the abdomen of the pregnant woman with an elastic belt. Due to the stroke changes caused by uterine contractions of a stylus, which acts mechanically on the strain gauge, an electrical signal is obtained which represents a measure of the labor activity and whose temporal course is evaluated by the general practitioner.

Das Verfahren der externen Tokographie weist den Nachteil auf, daß die indirekte Methode der Druckaufnahme zahlreichen Störeinflüssen ausgesetzt ist, welche das Meßergebnis verfälschen. Derartige Störeinflüsse stellen zum Beispiel schon die mit der Atmung einhergehenden Hubänderungen dar. Dem noninvasiven Verfahren liegt die Annahme zugrunde, daß der am Abdomen mittels des Taststiftes festgestellte und registrierte Druck eine hinreichende Näherung des intra- .uterinen Druckes darstellt. Mit dieser Messung läßt sich jedoch keine ausreichend genaue Information, über den Ver- auf der Uterusaktivität gewinnen.The method of external tokenography has the disadvantage that the indirect method of taking up pressure is exposed to numerous interferences which falsify the measurement result. Such disturbances already represent, for example, the changes in stroke associated with breathing. The non-invasive procedure is based on the assumption that the pressure detected and registered on the abdomen by means of the stylus represents a sufficient approximation of the intra-uterine pressure. With this measurement, however, it is not possible to obtain sufficiently precise information about the development of the uterine activity.

Figure imgb0001
Figure imgb0001

Aus der DE-OS 21 34 286 ist eine Vorrichtung zur Überwachung bei der Geburtshilfe bekannt, bei der die Phasen der Zusammenziehung und Erschlaffung des Uterus dadurch elektrisch ermittelt wird, daß an den Unterleib der Kreißenden ein Wechselstrom konstanter Stärke angelegt wird, daß das erzeugte Signal aufgefangen und demoduliert wird, daß das resultierende Signal registriert und mit der registrierten Kurve einer Bezugskennlinie verglichen wird. Der Nachteil dieser Vorrichtung besteht darin, daß mit Hilfe des angelegten Wechselstroms nur eine geringe Information über Wehenerregung und -ausbreitung erhalten wird. Ferner . besteht die Gefahr, daß der Wechselstrom einen schädlichen Einfluß auf den Feten hat.From DE-OS 21 34 286 a device for monitoring obstetrics is known, in which the phases of contraction and slackening of the uterus are determined electrically by applying an alternating current of constant strength to the abdomen of the gaggers that the generated signal is collected and demodulated so that the resulting signal is registered and compared with the registered curve of a reference characteristic. The disadvantage of this device is that with the help of the applied alternating current only a little information about labor excitation and spread is obtained. Furthermore. there is a risk that the alternating current has a harmful effect on the fetus.

Der Erfindung liegt die Aufgabe zugrunde, eine Vorrichtung zur Detektion und zur Registrierung der Uterusaktivität anzugeben, die von den vorgenannten Nachteilen frei ist und eine die Patientin nicht belästigende Untersuchungsmethode ermöglicht, welche vom behandelnden Arzt unter Verwendung einer kompakten Vorrichtung ohne Beeinträchtigung des Geburtsverlaufs routinemäßig durchgeführt werden kann. Die Auswertung der Meßergebnisse soll vom Arzt in relativ kurzer Zeit und ohne besonderen Aufwand vorgenommen werden können und zu einer sicheren Diagnose führen.The invention has for its object to provide a device for detection and registration of uterine activity, which is free from the aforementioned disadvantages and enables a patient method that is not a nuisance, which the attending physician routinely performs using a compact device without affecting the course of the birth can. The doctor should be able to evaluate the measurement results in a relatively short time and without any special effort and lead to a reliable diagnosis.

Die erfindungsgemäße Vorrichtung zeichnet sich aus durch Mittel zur elektromyographischen Erfassung der mit Muskelaktivitäten-einhergehenden elektrischen Felder im abdominalen Bereich als elektrische Signale, Mittel zur Erzeu-

Figure imgb0002
der Signale, die im wesentlichen der Intensität des Wechselspannungsanteils des elektromyographisch abgeleiteten Signals entsprechen, sowie Mittel zur Ausgabe des gemittelten Signals als Maß für den intrauterinen Druck.The device according to the invention is characterized by means for electromyographic detection of the electrical fields associated with muscle activity in the abdominal area as electrical signals, means for generating
Figure imgb0002
the signals which essentially correspond to the intensity of the AC voltage component of the electromyographically derived signal, and means for outputting the averaged signal as a measure of the intrauterine pressure.

Die Erfindung beruht auf der Erkenntnis, daß die-intrauterinen Druckänderungen direkt durch Muskelkontraktionen hervorgerufen werden. Die mit diesen Kontraktionen verbundenen elektrischen Felder sind elektromyographisch an der Hautoberfläche meßbar. Ein Maß für die Intensität der Kontraktionen ist dabei nicht direkt der gemessenen Spannungsverlauf, sondern, wie mit der Erfindung gefunden wurde, ein Mittelwert der impulsförmigen Wechselspannungsanteile der gemessenen Signale. Unter Intensität wird dabei ein Wert verstanden, der für den Betrag der Amplitude des Wechselspannungsanteils repräsentativ ist und beispielsweise durch Gleichrichtung des Wechselspannungsanteils . bzw. Quadrierung im Sinne einer Leistungsermittlung gewonnen werden kann. Das ausgegebene Signal verläuft damit im wesentlichen mindestens ähnlich wie eine Einhüllende des elektro-myographisch erfaßten Signals.The invention is based on the knowledge that the intrauterine pressure changes are caused directly by muscle contractions. The electrical fields associated with these contractions can be measured electromyographically on the surface of the skin. A measure of the intensity of the contractions is not directly the measured voltage curve, but, as was found with the invention, an average of the pulsed AC voltage components of the measured signals. Intensity is understood to mean a value that is representative of the magnitude of the amplitude of the AC voltage component and, for example, by rectifying the AC voltage component. or squaring can be obtained in the sense of a performance assessment. The output signal is thus essentially at least similar to an envelope of the electro-myographically detected signal.

Es ist damit eine Möglichkeit gegeben, den relativen . -uterinen Druck rein äußerlich mit einem Verfahren zu messen, das das Wohlbefinden der

Figure imgb0003
einträchtigt. Da das mittels
Figure imgb0004
Figure imgb0005
Figure imgb0006
So there is a possibility, the relative. - To measure uterine pressure purely externally using a method that measures the well-being of the
Figure imgb0003
impaired. Since that means
Figure imgb0004
Figure imgb0005
Figure imgb0006

Besonders vorteilhaft ist bei einem auf der erfindungsgemäßen Vorrichtung basierenden medizinischen Untersuchungsgerät, daß es sich wegen seiner einfachen Bedienbarkeit und sicheren Erfassung der zu ermittelnden Signale insbesondere für Routineuntersuchungen eignet, so daß sich nicht nur im klinischen Bereich ein weites Anwendungsfeld ergibt.It is particularly advantageous in the case of a medical examination device based on the device according to the invention that, owing to its simple operability and reliable detection of the signals to be determined, it is particularly suitable for routine examinations, so that there is a wide field of application not only in the clinical field.

Vorteilhaft ist weiterhin, daß in dem abdominal abgeleiteten Elektromyogramm die maternellen und fetalen Herzsignale zwar als Störsignale enthalten sind, diese aber gegebenenfalls ausgefiltert und getrennt ausgewertet werden können.It is also advantageous that the maternal and fetal heart signals are contained in the abdominally derived electromyogram as interference signals, but these can, if necessary, be filtered out and evaluated separately.

Außerdem ist bei der erfindungsgemäßen Vorrichtung günstig, daß die in der Messung. enthaltenen und so dem Arzt zugänglichen Informationen umfangreicher sind als, es bei der Verwendung von Druckaufnehmern der Fall ist. Da die Befestigung von Hautelektroden wesentlich einfacher vorzunehmen ist als die Anbringung von mechanischen Druckaufnehmern, wird die Ermittlung der Uterustätigkeit für den Arzt wesentlich erleichtert. Mit der Verringerung der pro Patientan aufzuwendenden Untersuchungszeit ist auch eine Senkung der Behandlungskosten verbunden.

Figure imgb0007
In addition, it is advantageous in the device according to the invention that the measurement. information contained and thus accessible to the doctor are more extensive than is the case when using pressure transducers. Since the attachment of skin electrodes is much easier to carry out than the attachment of mechanical pressure transducers, the determination of uterine activity is made considerably easier for the doctor. The reduction in the examination time to be spent per patient is also associated with a reduction in treatment costs.
Figure imgb0007

Wehenkurven lassen sich Rückschlüsse auf die Erregung und

Figure imgb0008
der Kontraktionen ziehen. Auf-dieses Weise kann
Figure imgb0009
auch frühzeitig Mot ilitätsstörungen,
Figure imgb0010
. spielsweise Inkoordination, erkenneh.Contractions can be used to draw conclusions about arousal and
Figure imgb0008
of contractions. That way it can
Figure imgb0009
also early motility disorders,
Figure imgb0010
. for example incoordination, recogniz.

Die Auswertung der Myosignale kann in vorteilhafter Weise durch Verwendung eines entsprechenden Bandfilters in einem Frequenzbereich von ca. 150 bis 250 Hz vorgenommen werden. Dabei ist es günstig, daß die bei der Erfassung der Uterusmotilität störenden Signalanteile von fetalem . und maternellem Elektrokardiogramm in diesem Frequenzbereich. amplitudenmäßig kleiner sind als die auszuwertenden Myopotentiale und daher das Ergebnis nur wenig beeinflussen.The evaluation of the myo signals can be carried out in an advantageous manner by using an appropriate bandpass filter in a frequency range of approximately 150 to 250 Hz. It is favorable that the signal components of fetal, which are interfering with the detection of uterine motility. and maternal electrocardiogram in this frequency range. are smaller in amplitude than the myopotentials to be evaluated and therefore have little influence on the result.

Eine weitere Möglichkeit bei der Ermittlung der Uterustätigkeit störende Signale in ihrer Auswirkung zu vermindern best-eht darin, die bei der Mittelwertbildung (durch Tiefpaßilterung) des gleichgerichteten oder quadrierten Signals benutzte Zeitkonstante hinreichend groß zu wählen. In diesem Fall kann (bei einer Zeitkonstante von mehreren Sekunden) sogar derjenige Frequenzbereich des myographisch aufgenommenen Signals von ungefähr 15 bis 40 Hz herangezo- . gen werden, in dem die Herzsignale ihr Maximum haben. Die Auswahl des auszuwertenden engeren Frequenzbereiches und dessen Breite innerhalb eines Gesamtbereiches von ungefähr 10 bis 300 Hz hängt davon ab, ob die statischen oder dynamischen Anteile der Muskelkontrakt ionen bevorzugt ausgegeben werden sollen und in welchem Umfang -der Einfluß der Bauchmuskulatur (Anspannung bei Preßwehen)-im Ergebnis erscheinnen solleq

Figure imgb0011
Another way of reducing the effect of interfering signals on the determination of uterine activity is to make the time constant used for averaging (by low-pass filtering) the rectified or squared signal sufficiently large. In this case, even that frequency range of the myographically recorded signal of approximately 15 to 40 Hz can be used (with a time constant of several seconds). where the heart signals have their maximum. The selection of the narrower frequency range to be evaluated and its width within a total range of approximately 10 to 300 Hz depends on whether the static or dynamic parts of the muscle contract ions should be given out and to what extent the influence of the abdominal muscles (tension in the case of presses) - should appear in the result
Figure imgb0011

Die Ausgabe der gemittelten Signale, die ein Maß für den intrauterinen Druck bilden, kann in vorteilhafter Weise

Figure imgb0012
The output of the averaged signals, which form a measure of the intrauterine pressure, can advantageously
Figure imgb0012

Wird das gemittelte Signal potenziert, so werden die Maxima der Wehenkurven besonders deutlich sichtbar.If the averaged signal is potentiated, the maxima of the contractions are particularly clearly visible.

Die Signalverarbeitung kann in besonders einfacher Weise mittels analog abeitender Baugruppen wie Operationsverstärkern erfolgen. Wird die erfindungsgemäße Vorrichtung mit einer solchen zur Ermittlung der Herztätigkeit zusammengefaßt, so wird die Signalverarbeitung günstigerweise digital, vorzugsweise mittels Mikroprozessoren, vorgenommen.The signal processing can be carried out in a particularly simple manner by means of analog modules such as operational amplifiers. If the device according to the invention is combined with one for determining cardiac activity, the signal processing is advantageously carried out digitally, preferably by means of microprocessors.

Ihre besonderen Vorzüge entfaltet die erfindungsgemäße Vorrichtung in dem Fall, daß mittels abdomidal angebrachter Elektroden gleichzeitig sowohl die Uterus- als auch dienfetale (bzw. die maternelle) Herztätigkeit betroffene Signale abgeleitet werden bzw. die aufgenommenen Signale in einem gemeinsamen Gerät ausgewertet werden. Damit besteht die Möglichkeit, im Rahmen perinat alersdntersuchungen mit einer einzigen, die Patientin wenig belastenden Messung umfangreiche Daten zu gewinnen,

Figure imgb0013
in die Lage versetzen, schnell ein genaues
Figure imgb0014
den: Zustand des Feten und der Patientin zu
Figure imgb0015
so daß er r die erforderlichen Maßnahmen
Figure imgb0016
The device according to the invention exhibits its particular advantages in the case that signals affecting both the uterus and the fetal (or maternal) cardiac activity are derived simultaneously by means of electrodes attached to the abdomen, or the recorded signals are evaluated in a common device. This means that there is the option of performing one-on-one examinations with a single patient that is not very stressful Measurement to gain extensive data
Figure imgb0013
enable you to quickly get an accurate
Figure imgb0014
den: Condition of the fetus and the patient
Figure imgb0015
so that he takes the necessary action
Figure imgb0016

Wird dabei der auszuwertende Frequenzbereich, wie oben dargestellt, unter Wahl einer entsprechend großen Zeitkonstanten für die Mittelung so gelegt, daß er den Bereich der von den Herzsignalen eingenommenen Frequenzen (mit-) umfaßt, so sind keine weiteren Filtermittel erforderlich, um die Signale für die Ermittlung der Uterustätigkeit von denen für die Ermittlung der Herztätigkeit zu trennen.If the frequency range to be evaluated, as shown above, is selected by selecting a correspondingly large time constant for the averaging so that it includes the range of the frequencies taken up by the heart signals, no further filtering means are required to filter the signals for the Detect uterine activity from those for determining heart activity.

Wenn Mittel vorgesehen sind, um die Signalauswertung beeinträchtigende wiederkehrende Störsignale nach einem ersten Kriterium zu erkennen, in seinem Amplitudenverlauf in einem Speicher festzuhalten und, wenn das Auftreten eines Störsignals im Eingangssignal entdeckt ist, von diesem amplitudenmäßig phasenrichtig zu subtrahieren, so ist damit die Möglichkeit gegeben, die Auswertung beeinträchtigende Signalanteile, wie den maternellen QRS-Komplex, sowohl hinsichtlich der die Uterus-, als auch hinsichtlich der die Herztätigkeit betreffenden Signale durch gemeinsame Mittel zu beseitigen. Die weitere Auswertung werfolgt dabei für die Herzsignale zweckmäßigerweise, wie es in der deutschen Patentanmeldung P.27 16 739.1 beschrieben ist. Werden dabei ein oder mehrere Mikroprozessoren verwendet, so können diese mittels einer geeigneten Programmierung für die die Ausgabe der die Uterustätigkeit betreffenden Signale notwendigen mathematischen Operationen mitbenutzt werden.If means are provided for recognizing recurring interfering signals impairing the signal evaluation according to a first criterion, the amplitude course of them is recorded in a memory and, if the occurrence of an interfering signal in the input signal is detected, subtracting it in the correct phase in terms of amplitude, this is possible to eliminate signal components which impair the evaluation, such as the maternal QRS complex, both with regard to the signals relating to the uterus and with regard to the cardiac activity by common means. The further evaluation is expediently carried out for the heart signals, as described in German patent application P.27 16 739.1. If one or more microprocessors are used, they can be used by means of suitable programming for the mathematical operations necessary for the output of the signals relating to uterine activity.

Figure imgb0017

  • Fig. 1 eine Darstellung der Signalaufnahme,
  • Fig.2 ein Blockschaltbild einer ersten
    Figure imgb0018
    der erfindungsgemäßen Vorrichtung, bei der
    Figure imgb0019
    Mittel vorgesehen. sind, um die fetale bzw. maternelle Herztätigkeit zu ermitteln,
  • Fig.3 ein Schaltbild eines Verstärkers für das elektro- myographisch aufgenommene abdominale Signal als Darstellung eines Details der in Fig. 2 schematisch
    Figure imgb0020
    Vorrichtung,
  • Fig.4 ein. Schaltbild des Verarbeitungsteils für das 8) tromyogramm, ebenfalls als Detaildarstellung eines Blog der schematischen Darstellung gemäß Fig. 2 sowie
  • Fig.5 ein Blockschaltbild einer zweiten Ausführungsfon der Erfindung gemäß Fig. 2, mit Mitteln zur Befreiung d. zu verarbeitenden Signale von stören den mat ernellen He signalen (QRS-Komplexen).
Figure imgb0017
  • 1 is a representation of the signal recording,
  • 2 shows a block diagram of a first
    Figure imgb0018
    the device according to the invention, in which
    Figure imgb0019
    Funds provided. are to determine the fetal or maternal heart activity,
  • 3 shows a circuit diagram of an amplifier for the electromographically recorded abdominal signal as a representation of a detail of the one in FIG. 2 schematically
    Figure imgb0020
    Contraption,
  • Fig.4 a. Circuit diagram of the processing part for the 8) tromyogram, also as a detailed representation of a blog of the schematic representation according to FIG. 2 and
  • 5 shows a block diagram of a second Ausführungsfon the invention according Fi g. 2, with means of exemption d. signals to be processed from disrupt the maternal He signals (QRS complexes).

In Fig. 1 ist eine Darstellung der Signalautnahme wiede geben. Verschiedene Elektroden 301, 302 und 303 sind zu Meßwertaufnahme am Körper einer Patientin 304 angebrach deren Wehentätigkeit erfaßt werden soll. Bei einer Weit bildung der Erfindung wird dabei gleichzeitig die Herzt tigkeit eines Feten 305 untersucht. In dem mittels dec Haut-Elektroden 301 bis 303 elektromyographisch aufgenom menen Signalverlauf 306 ist das Signal vom Herzen 307 de Feten überlagert vom Signal des Herzens 308 der Mutter sowie verschiedenen Störanteilen. Das fetale bzw. das ma ternelle Herzsignal ist im Signalverlauf 306 mehrfach mi "f" bzw. "m" gekennzeichnet. Die die Wehentätigkeit repr sentieren Signale sind im aufgenommenen Signal nicht direkt erkennbar und werden erst durch die erfindungsgemäße Vorrichtung als Kurvenverlauf darstellbar.In Fig. 1 is a representation of the signal acquisition give again. Various electrodes 301, 302 and 303 are attached to the measurement value on the body of a patient 304 whose contraction is to be recorded. In a wide development of the invention, the heart activity of a fetus 305 is examined at the same time. In the means of dec Skin electrodes 301 to 303 electromyographically recorded signal course 306, the signal from the heart 307 de fetus is superimposed by the signal from the heart 308 of the mother and various interference components. The fetal or the maternal heart signal is repeatedly identified with mi "f" or "m" in the signal curve 306. The signals representing labor are not directly recognizable in the recorded signal and can only be represented as a curve by the device according to the invention.

Die in Fig. 2 dargestellte erste Ausführungsform der erfindngsgemäßen Vorrichtung ermöglicht die Ermittlung und Aufzeichnung der Uterusaktivität durch die Erkennung und Auswertung von Muskelkontraktionen im Abdominalbereich. Der Eingang eines Verstärkers 1, der im einzelnen in Fig 3 schaltungsmäßig dargestellt ist, ist über seine Eingäng 2 mit den hier nicht dargestellten Elektroden verbunden.The first embodiment of the device according to the invention shown in FIG. 2 enables the determination and recording of uterine activity by the detection and evaluation of muscle contractions in the abdominal area. The input of an amplifier 1, which is shown in detail in FIG. 3, is connected via its inputs 2 to the electrodes (not shown here).

Das Signal vom Ausgang 7 des Verstärkers 1. wird einem Eir gang 8 eines Verarbeitungsteils 3 zugeleitet, mittels des sen die die Uterustätigkeit betreffenden Signalanteile so aufbereitet werden, daß das einem Ausgang 4 zugeleitete Signal des Verarbeitungsteils 3 ein Maß für die Uterusmotilität darstellt. Mit dem Ausgang 4 ist ein. nicht dargestelltes Registriergerät verbunden, welches den Verlauf der Intensität der Wehentätigkeit in Abhängigkeit von der Zeit aufzeichnet, so daß der Arzt aus den sich ergebenden charakteristischen Kurvenverläufen, gegebenenfalls durch Vergleich mit in einem Verzeichnis aufgeführten Kurvenver läufen, Rückschlüsse auf die Wehentätigkeit ziehen kann. Die Schaltung des Verarbeitungsteils 3 ist im einzelnen il Fig. 4 dargestellt.The signal from the output 7 of the amplifier 1 is fed to an output 8 of a processing part 3, by means of which the signal components relating to uterine activity are processed in such a way that the signal supplied to output 4 of the processing part 3 represents a measure of the uterine motility. With output 4 is a. Connected recording device, not shown, which records the course of the intensity of the contractions as a function of time, so that the doctor can draw conclusions about the contractions from the resulting characteristic curves, possibly by comparing them with curves listed in a directory. The circuit of the processing part 3 is shown in detail in FIG. 4.

Bei der dargestellten Ausführungsform der

Figure imgb0021
Figure imgb0022
Vorrichtung ist die
Figure imgb0023
Figure imgb0024
1 wird dazu zu einem Verarbeitungsteil 5 für die Herzsignale abgezweigt. (Die Möglichkeiten zur Trennung der beiden Signale werden dabei weiter unten näher erläuter Am Ausgang 6 des Verarbeitungsteils 5 stehen das fetals Elektrokardiogramm oder ein Signal als Maß für die Herz frequenz zur Verfügung und können beispielsweise in ihr zeitabhängigen Kurvenverlauf wiedergegeben werden. Die Darstellung der fetalen Herzsignale läßt sich mit derje nigen der Uterustätigkeit in einem Kardiotokogramm zus menfassen, welches von einem einzigen graphischen Ausge gerät dargestellt werden kann.In the illustrated embodiment of the
Figure imgb0021
Figure imgb0022
Device is the
Figure imgb0023
Figure imgb0024
1 is branched off to a processing part 5 for the heart signals. (The options for separating the two signals are explained in more detail below. The output 6 of the processing part 5 provides the fetal electrocardiogram or a signal as a measure of the heart rate and can be reproduced, for example, in its time-dependent curve profile. The representation of the fetal heart signals can be summarized with those of uterine activity in a cardiotocogram, which can be displayed by a single graphic device.

In Fig. 3 ist das vollständige

Figure imgb0025
für das abdominale Signal (1 in Fig. 2)
Figure imgb0026
Über den Eingang 2 gelangen die
Figure imgb0027
nalelektroden zu einem
Figure imgb0028
Potentialtrennung von Patientin und Meßgerät dient. Di Ausgänge des Trennverstärkers T 1 sind mit den Eingäng eines Differenzverstärkers verbunden, welcher aus eine Operationsverstärker OP 1 besteht, der mit einer Anzahl von Widerständen und Kondensatoren beschaltet ist Die Widerstände R 1 und R 3 bzw. R 2 und R 4 bilden mi den Kondensatoren C 2 bzw. C 3 jeweils einen Eingangs-Tiefpaß, während die widerstands-kondensator-kombinati C 1/R 5 und C 4/R 6 sowie der Kondensator C 5 für eine Verstärkungsabfall zu hohen Frequenzen hin sorgen, Die nachfolgende Stufe, welche den Operationsverstärker OF enthält, ist in üblicher Weise als
Figure imgb0029
geschaltet, wobei im dargestellten Ausführungsbeispiel die Werte der widerstände R 7 bis R 10 und die der
Figure imgb0030
. satoren C 6 bis C 9 so gewählt sind, daß die
Figure imgb0031
vorzugsweise die tiefen Frequenzen des abdominalen Signals beschneidet. Die letzte einen Operationsverstärker OP 3 enthalt ende Stufe arbeltet als reine wechseispannungsgekoppelte Verstärkerschaltung, wobei der
Figure imgb0032
durch das Verhältnis der widerstände R 11 und R 13 bestimmt wird und ein Mullabgleich des Ausgangssignals über den widerstand R 12 mittels eines veränderlichen widerstands R 15 erfolgen kann. Die Gesamtschaltung des Verstärkers für das abdominale Signal bewirkt eine erste Beschneidung der bei der nachfolgenden Signalverarbeitung - storenden-Frequenzen.3 is the complete one
Figure imgb0025
for the abdominal signal (1 in Fig. 2)
Figure imgb0026
Via the entrance 2 the
Figure imgb0027
nal electrodes to one
Figure imgb0028
Isolation of patient and measuring device is used. The outputs of the isolation amplifier T 1 are connected to the inputs of a differential amplifier, which consists of an operational amplifier OP 1, which is connected to a number of resistors and capacitors. The resistors R 1 and R 3 or R 2 and R 4 form the capacitors C 2 and C 3 each have an input low-pass filter, while the resistance-capacitor combinations C 1 / R 5 and C 4 / R 6 as well as the capacitor C 5 provide a gain drop to high frequencies, the subsequent stage, which the Operational amplifier OF is in the usual way as
Figure imgb0029
switched, the values of the resistors R 7 to R 10 and those of the illustrated embodiment
Figure imgb0030
. C 6 to C 9 are selected so that the
Figure imgb0031
preferably cut the low frequencies of the abdominal signal. The last stage containing an operational amplifier OP 3 works as a pure AC-coupled amplifier circuit, the
Figure imgb0032
is determined by the ratio of the resistors R 11 and R 13 and a garbage comparison of the output signal can be carried out via the resistor R 12 by means of a variable resistor R 15. The overall circuit of the amplifier for the abdominal signal brings about a first trimming of the frequencies interfering in the subsequent signal processing.

In Fig. 4 ist die Schaltung des Verarbeitungsteils für dis Elektromyogramm (3 in Fig. 2) dargestellt. Durch die - beiden ersten Studen mit den Operationsverstärkern OP 4 und OP 5 wird eine Sandpaßfilterung des an Eingang des Verarbeitungsteils 3 erscheinenden Signals vorgenommen. Das Bandpaßfilter weist die Frequenzgrenzen fu = 150 Hz und fo = 250 Hz auf, da in diesem Frequenzbereich die Leistung der uterinen Akt ionspotentiale diejenige der Störanteile übercrifft. Die Beschaltung der Operationsverstärker OP 4 und OP 5 mit widerständen R 16 bis R 26 und Kondensatoren C 12 bis. C 15 entspricht in der Funltion derjenigen des Operationsverstärkers OP 2 in Fig. 3. Die Bemessung der Werte der Bauelemente geht aus der anliegen- den Stückliste hervor. Sie erfolgt nach den für deramge aktive Filterschaltungen gültigen Regeln. Eine Einstellung des Ausgangspegels und der Güte des Filters läßt sich mittels des veränderlicher widerstands R 24 vornehmea.

Figure imgb0033
4 shows the circuit of the processing part for the electromyogram (3 in FIG. 2). The first two hours with the operational amplifiers OP 4 and OP 5 sand-pass filter the signal appearing at the input of the processing part 3. The bandpass filter has the frequency limits f u = 150 Hz and f o = 250 Hz, since in this frequency range the power of the uterine ion potentials exceeds that of the interference components. The circuitry of the operational amplifiers OP 4 and OP 5 with resistors R 16 to R 26 and capacitors C 12 to. The function of C 15 corresponds to that of the operational amplifier OP 2 in FIG. 3. The dimensioning of the values of the components is evident from the attached parts list. It takes place according to the rules valid for deramge active filter circuits. The output level and the quality of the filter can be set by means of the variable resistor R 24.
Figure imgb0033

Frequenzbereiche für die Ermittlung der Uterustätigkeit auszunutzen, welche von den Herzsignalen überlagert sind. Damit ist eine konstruktiv besonders einfache Ausführungsform möglich, bei der auf getrennte Filtermittel zum Beseitigen des bei der Uterusaktivität störenden maternellen Herzsignals verzichtet werden kann. Bei einer anderen Ausführungsform der Erfindung ist an dieser Stelle eine auf die Gleichrichterschaltung folgende Stufe zur digitalen bzw. analogen Bildung des quadratischen Mittelwerts der Signale eingefügt.

Figure imgb0034
Figure imgb0035
Figure imgb0036
wobei
Figure imgb0037
Figure imgb0038
subtrahiereten Signals an
Figure imgb0039
nals angepaßt.To use frequency ranges for the determination of uterine activity, which are superimposed by the heart signals. This makes a structurally particularly simple embodiment possible, in which separate filter means for eliminating the maternal heart signal, which interferes with uterine activity, can be dispensed with. In another embodiment of the invention, a stage following the rectifier circuit for digital or analog formation of the root mean square of the signals is inserted at this point.
Figure imgb0034
Figure imgb0035
Figure imgb0036
 in which
Figure imgb0037
Figure imgb0038
subtracted signal
Figure imgb0039
nals adapted.

Das derart von störenden Anteilen befreite Signal dient als Eingangssignal für einen Signal-Verarbeitungsteil 3', in dem die die Uterustätigkeit betreffenden Signale, wie anhand des Verarbeitungsteils 3 beschrieben, vorgenommen wird. (Im Gegensatz zu dem in Fig. 4 dargestellten Verarbeitungsteil 3 ist bei dem Verarbeitungsteil 3' die Bandfilterbaugruppe weggelassen, da die Filterung gemeinsam durch das Filter 203 erfolgt.) In einem Bewertungsteil 209 kann eine logarithmische oder auch potenzierende Verzerrung der ausgegebenen Amplitudenwerte erfolgen, die mitcels eines Wehenschreubers 210 zeitabhängig craphisch dargestellt werden.The signal freed from disturbing components in this way serves as an input signal for a signal processing part 3 'in which the signals relating to uterine activity are carried out, as described with reference to processing part 3. (In contrast to the processing part 3 shown in FIG. 4, the band filter assembly is omitted in the processing part 3 ', since the filtering is carried out jointly by the filter 203.) A logarithmic or potentiating distortion of the output amplitude values can take place in an evaluation part 209 can be represented graphically as a function of time using a contraction wrench 210.

Figure imgb0040
fortlaufend an die aktuelle Signalform angepaßt wird. Der Mittelwert des fetalen EKG (QRS-Komplex) ist in Stufe 207 festgehalten, während in Stufe 208 aus dem zeitliche Abstand der fetalen Herzsignale die fetale Herzfrequenz errechnet und festgehalten wird.
Figure imgb0040
is continuously adapted to the current waveform. The mean value of the fetal ECG (QRS complex) is recorded in step 207, while in step 208 the fetal heart rate is calculated and recorded from the time interval between the fetal heart signals.

Figure imgb0041
ten realisiert. Diese Ausführung ist dann besonders günstig, wenn sie für sich allein benutzt werden soil. In einer digitalen Ausführung, bei der bei Verwendung im Zusammenhang mit anderen Erfassungseinrichtungen für Patientendäten vorhandene Datenverarbeitungseinrichtungen, wie Mikroprozessoren, vorteilhaft mitbenutzbar sind, kön- nen für die erforderlichen mathematischen Berechnungen (Mittelwertbildung, Leistungs-, RMS-Ermittlung, Logarithmierung, Potenzbi dung) Programme oder Programmteilebenutzt werden, wie sie beispielsweise in den für die entsprechenden Datenverarbeitungseinrichtungen oder Mikroprozessoren (z.B. LSI 11 oder 8080) zur Verfügung stehenden Programmsammlungen enthalten sind.
Figure imgb0041
realized. This version is particularly cheap if it should be used alone. In a digital version, in which existing data processing devices, such as microprocessors, can advantageously also be used when used in conjunction with other recording devices for patient data, programs can be used for the required mathematical calculations (averaging, performance, RMS determination, logarithming, power generation) or program parts are used, such as those contained in the program collections available for the corresponding data processing devices or microprocessors (eg LSI 11 or 8080).

Stückliste

  • a) Schaltung gemäß Fig. 3
    Figure imgb0042
  • b) Schaltung gemäß Fig. 4
    Figure imgb0043
parts list
  • a) Circuit according to FIG. 3
    Figure imgb0042
  • b) Circuit according to FIG. 4
    Figure imgb0043

Claims (17)

1. Vorrichtung zur Detektion und Registrierung der Ut rusaktivität mittels elektrischer Signale, geken zeichnet durch Mittel zur elektromyographischen Erfassung der mit Mus aktivitäten einhergehenden elektrischen Felder im abdc nalen Bereich (Elektroden 301 bis 303) als elektrische Signale, Mittel zur Erzeugung von Signalen, die im-wesentlicher der Intensität der Wechselspannungsanteile der elektrc myographisch abgeleiteten Signale entsprechen (OP 6, OP 7), Mittel zur zeitlichen Mittelung (C 16, R 31) der Signa die im wesentlichen der Intensität des Wechselspannunc teils der elektromyographisch abgeleiteten Signale ent sprechen, sowie Mittel zur Ausgabe des gemittelten Signals als Maß für intrauterinen Druck (Wehenschreiber 210). 1. Device for the detection and registration of ut rus activity by means of electrical signals, characterized by Means for the electromyographic detection of the electrical fields associated with mus activities in the abdc nal area (electrodes 301 to 303) as electrical signals, Means for generating signals which essentially correspond to the intensity of the alternating voltage components of the signals derived electrically (OP 6, OP 7), Means for temporal averaging (C 16, R 31) of the Signa which essentially correspond to the intensity of the alternating voltage part of the electromyographically derived signals, and Means for outputting the averaged signal as a measure of intrauterine pressure (contraction chart 210). 2. Vorrichtung nach Anspruch 1, dadurch ge- kennzeichnet, daß die Mittel zur Erzeugung von Signalen Signale abgeben, die im wesentlichen ein Maß für die elektrische Leistung des Wechselspannungsanteils des elektromyographisch abgeleiteten Signals darstellen.2. Device according to claim 1, characterized in that the means for generating signals emit signals which essentially represent a measure of the electrical power of the AC voltage component of the electromyographically derived signal. 3. Vorrichtung nach Anspruch 1, dadurch ge- kennzeichnet, daß Mittel zur Gleichrichtung der Wechselspannungsanteile (OP 6, OP 7) vorgesehen sind.3. Device according to claim 1, characterized in that means for rectifying the AC voltage components (OP 6, OP 7) are provided. 4. Vorrichtung nach Anspruch 3., dadurch ge- kennzeichnet, daß die Mittelung im wesentlichen quadratisch erfolgt.4. The device according to claim 3, characterized in that the averaging takes place essentially square. 5. Vorrichtung nach Anspruch 1, dadurch ge- kennzeichnet, daß die Mittel zur Erzeugung von Signalen Signale abgeben, die im wesentlichen dem Effektiv-(RMS-)Wert des Wechselspannungsanteils der elektromyographisch abgeleiteten Signale entsprechen.5. The device according to claim 1, characterized in that the means for generating signals emit signals which correspond essentially to the effective (RMS) value of the AC voltage component of the electromyographically derived signals. 6. Vorrichtung nach einem der vorangehenden Ansprüche, dadurch gekennzeichnet, .daß die Mit tel zur zeitlichen Mittelung einen Tiefpaß (C 17/ R 38) aufweisen.6. Device according to one of the preceding claims, characterized in that the means for tel averaging have a low pass (C 17 / R 38). 7. Vorriyhtung nach Anspruch 6, dadurch ge kennzeichnet, daß die Zeitkönstante des Ti passes mehrere Sekunden beträgt.7. Vorriyhtung according to claim 6, characterized in that the time constant of the Ti passes is several seconds. 8. Vorrichtung nach einem der vorangehenden Ansprüche dadurch gekennzeichnet, daß ein Filter (OP 4, OP 5) vorgesehen ist, um einen vorgegebe nen Frequenzbereich des Wechselspannungsanteils der elelekbromyographisch abgeleiteten Signale für die Auswertung abzutrennen.8. Device according to one of the preceding claims, characterized in that a filter (OP 4, OP 5) is provided in order to separate a predetermined frequency range of the AC voltage component of the elecromyographically derived signals for the evaluation. 9.' Vorrichtung nach Anspruch 8, dadurch ge kennzeichnet, daß der vorgegebene Frequenz bereich im wesentlichen innerhalb der Grenzen von 150 250 Hz liegt.9. ' Apparatus according to claim 8, characterized in that the predetermined frequency range is substantially within the limits of 150 250 Hz. 10. Vorrichtung nach einem der vorangehenden Ansprüch dadurch gekennzeichnet, daß Mitt zur Ausgabe des gemittelten Signals in Logarithmischer Darstellung vorgesehen sind.10. Device according to one of the preceding claims, characterized in that Mitt are provided for output of the averaged signal in logarithmic representation. 11. Vorrichtung nach einem der Ansprüche 1 bis 9, da- durch gekennzeichnet, daß Mittel zu Ausgabe des gemittelten Signals in potenzierter Darstel lung vorgesehen sind.11. The device according to one of claims 1 to 9, characterized in that means for outputting the averaged signal are provided in exponential representation. 12. Vorrichtung nach einem der vorangehenden Ansprüche dadurch gekennzeichnet , daß für
Figure imgb0044
12. Device according to one of the preceding claims, characterized in that for
Figure imgb0044
 13. Vorrichtung nach den Ansprüchen 8 und 12, da-durch gekennzeichnet, daß die über gemeinsame Meßwertaufnehmer myographisch erfaßten Signale für-die Auswertung durch Bandfiltermittel im wesentlichen auf. einen Frequenzbereich von 15 bis 40 Hz begrenzt werden.13. Device according to claims 8 and 12, characterized in that the signals recorded myographically via common transducers for the evaluation by band filter means essentially on. a frequency range of 15 to 40 Hz can be limited. 14. Vorrichtung nach einem der Ansprüche 12 oder 13, dadurch gekennzeichnet, daß Mitte vorgesehen sind, um die Signalauswertung beeinträchtige wiederkehrende Störsignale nach einem ersten Kriterium erkennen, in seinem Amplitudenverlauf in einem Speicher festzuhalten und, wenn das Auftreten eines Störsignals Eingangssignal entdeckt ist, von diesem amolitudenmäßig phasenrichtig zu subtrahieren.14. Device according to one of claims 12 or 13, characterized in that the center are provided in order to recognize the signal evaluation impairing recurring interference signals according to a first criterion, to record in its amplitude profile in a memory and, if the occurrence of an interference signal input signal is detected, by to subtract this in the right phase in terms of amolitudes. 15. Vorrichtung nach Anspruch 16 zur Ermittlung fetale Herzsignale, dadurch gekennzeich- net, daß es sich bei dem wiederkehrenden Störsignal den maternellen QRS-Komplex handelt.15. The apparatus of claim 16 for determining fetal heart signals, characterized in that it is the maternal QRS complex in the recurring interference signal. 16. Vorrichtung nach einem der Ansprüche 12 bis 15, dadurch gekennzeichnet , daß zur En deckung von QRST-Komplexen fetaler Herzsignale im von dE Signalen zur Detektion und Registrierung der Uterusaktivi tät getrennten Eingangssignal ein Speicher zum Festhalter eines nach einem ersten Kriterium erkannten fetalen QRS- Komplexes in seinem Amplitudenverlauf vorgesehehen ist und letzterer als Muster zur Identifikation nachfolgender QRS Komplexe nach einem zweiten Kriterium herangezogen wird, das in dem Maß der Übereinstimmung des jeweils anliegende Signals mit dem Amplitudenverlauf des als Muster festgehaltenen fetalen QRS-Komplexes besteht.16. The device according to one of claims 12 to 15, characterized in that for the coverage of QRST complexes fetal heart signals in the d E Signals for the detection and registration of the uterine activity separated input signal, a memory for recording a fetal QRS complex recognized according to a first criterion is provided in its amplitude profile and the latter is used as a pattern for the identification of subsequent QRS complexes according to a second criterion, which is used to the extent of There is agreement between the signal present in each case and the amplitude profile of the fetal QRS complex recorded as a pattern. 17. Vorrichtung nach einem der-Ansprüche 14 bis 16, da durch gekennzeichnet, daß Mittel vorge sehen sind, um den als Muster festgehaltenen fetalen QRS-Komplex un seinem Amplitudenverlauf fortwährend an die aktuelle Form des fetalen QRS-Komplexes anzupassen.17. The device according to any one of claims 14 to 16, characterized in that means are provided to adapt the fetal QRS complex recorded as a pattern and its amplitude profile continuously to the current shape of the fetal QRS complex.
EP78100372A 1977-07-13 1978-07-12 Circuit arrangement for the detection and recording of the activity of the uterus Expired EP0000504B1 (en)

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EP0000504B1 (en) 1982-05-19
DE2732160B2 (en) 1979-09-06
US4256118A (en) 1981-03-17
DE2732160A1 (en) 1979-01-18
DE2732160C3 (en) 1980-05-14
JPS5419595A (en) 1979-02-14
DE2861844D1 (en) 1982-07-08

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