EP0000504A1 - Circuit de commutation électrique pour la détection et l'enregistrement de l'activité de la matrice - Google Patents

Circuit de commutation électrique pour la détection et l'enregistrement de l'activité de la matrice 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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EP
European Patent Office
Prior art keywords
signals
signal
essentially
derived
detection
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
EP78100372A
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German (de)
English (en)
Other versions
EP0000504B1 (fr
Inventor
Joachim Nagel
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Biotronik SE and Co KG
Original Assignee
Biotronik Mess und Therapiegeraete GmbH and Co
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
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Application filed by Biotronik Mess und Therapiegeraete GmbH and Co filed Critical Biotronik Mess und Therapiegeraete GmbH and Co
Publication of EP0000504A1 publication Critical patent/EP0000504A1/fr
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Publication of EP0000504B1 publication Critical patent/EP0000504B1/fr
Expired legal-status Critical Current

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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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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Medical Informatics (AREA)
  • Veterinary Medicine (AREA)
  • Molecular Biology (AREA)
  • Physics & Mathematics (AREA)
  • Public Health (AREA)
  • Biophysics (AREA)
  • Pathology (AREA)
  • Engineering & Computer Science (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Biomedical Technology (AREA)
  • Cardiology (AREA)
  • Reproductive Health (AREA)
  • Pregnancy & Childbirth (AREA)
  • Gynecology & Obstetrics (AREA)
  • Urology & Nephrology (AREA)
  • Pediatric Medicine (AREA)
  • Measurement And Recording Of Electrical Phenomena And Electrical Characteristics Of The Living Body (AREA)
  • Measuring Pulse, Heart Rate, Blood Pressure Or Blood Flow (AREA)
  • Measuring And Recording Apparatus For Diagnosis (AREA)
EP78100372A 1977-07-13 1978-07-12 Circuit de commutation électrique pour la détection et l'enregistrement de l'activité de la matrice Expired EP0000504B1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE2732160A DE2732160C3 (de) 1977-07-13 1977-07-13 Vorrichtung zur Detektion und Registrierung der Uterusaktivität
DE2732160 1977-07-13

Publications (2)

Publication Number Publication Date
EP0000504A1 true EP0000504A1 (fr) 1979-02-07
EP0000504B1 EP0000504B1 (fr) 1982-05-19

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EP78100372A Expired EP0000504B1 (fr) 1977-07-13 1978-07-12 Circuit de commutation électrique pour la détection et l'enregistrement de l'activité de la matrice

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US (1) US4256118A (fr)
EP (1) EP0000504B1 (fr)
JP (1) JPS5419595A (fr)
DE (2) DE2732160C3 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0028202A1 (fr) * 1979-10-26 1981-05-06 BIOTRONIK Mess- und Therapiegeräte GmbH & Co Ingenieurbüro Berlin Dispositif de réglage d'amplitude pour signaux enregistrés électromyographiquement

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0028202A1 (fr) * 1979-10-26 1981-05-06 BIOTRONIK Mess- und Therapiegeräte GmbH & Co Ingenieurbüro Berlin Dispositif de réglage d'amplitude pour signaux enregistrés électromyographiquement

Also Published As

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

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