A method for predicting discoordination labor in pregnant women risk group
The invention relates to medicine, obstetrics and gynecology. Pregnant women risk group with 37 weeks of gestation register fluctuations in heart rate. Registration is done in the low frequencies (LF) and high frequency (HF). Discoordination labor activity predicted by the values of LF and HF. The method is non-invasive, simple, allows early prediction. table 1.
The invention relates to medicine, namely to obstetrics, and can be used to predict the development of discoordination labor in pregnant women at risk.
The urgency of development due to increased frequency of anomalies labor (DGS) to 17-30% (1, 3), of which discoordinated up to 3% (2, 3). Pathology contractile activity of the uterus leads to an increase in the duration of delivery, number of surgical interventions, the frequency of obstetric injuries, pathological blood loss, intrauterine fetal hypoxia. Dramatically increased perinatal mortality and mestorozhdenii (4).
A significant number of diagnostic and prognostic tests used for predicting the course of childbirth (clinical, and which enable to determine only the risk of developing pathology of labor, and in relation to the individual characteristics of women do not provide the realization of the forecast.
There is a method of predicting discoordination labor activity by determining the blood from the cervix activity adenozindezaminazy and increase the norm predict discoordination labor activity (5).
The disadvantages of the method:
1) the enzyme adenozindezaminazy has a pronounced age-related dynamics and depends on immunodeficiency, extragenital pathology, polyhydramnion, etc.;
2) carrying out the reaction requires mandatory production control to determine non-specific phosphatase, which in pregnant women has initially changed level;
3) may contribute to the development of inflammatory complications;
5) how is traumatic;
6) the lack of data on the accuracy of the method.
The closest technical solution to the claimed method is a method for predicting anomalies labor before birth by ultrasound echography the body of the uterus on the border with the lower segment. When identifying hyperechoic line on the background hypoechoic myometrium forecast is flexible (30%);
2) late in the forecast the day before delivery;
3) to perform the method requires expensive ultrasound equipment and trained specialist ultrasonographer;
4) lack of data on the accuracy of the method.
These drawbacks can be eliminated in the proposed method.
The technical result of this method is the prediction of discoordination labor in pregnant women risk group on the basis of determination with 37 weeks of gestation according to the spectral analysis of heart rate indices, reflecting fluctuations in heart rate in the low frequencies (LF norm)* (* LF norm reflects fluctuations in heart rate in the low frequencies from 0.04 to 0.15 Hz.) in the high frequency (HF norm)** (** HF norm reflects fluctuations in heart rate in the high frequencies from 0.15 to 0.40 Hz (9)), expressed as a percentage, and when values of LF norm equal to 53,9% or less, and HF norm equal to 46.1 per cent or more, forecast discoordinating generic activities with an accuracy of 87.8%.
Earlier spectral analysis of HRV was used in cardiology for the diagnosis of cardiac arrhythmias, pathology of the coronary arteries, and was also used as a method of formalizability heart rhythm has been used in various computer programs (we have taken the program “Polyspectra”, registration certificate №29/02020300/1987-01 dated 27.07.2001, the firm “Neurosoft”, Ivanovo). Spectral analysis identifies and quantifies the periodic changes in the frequency of sinus rhythm (7, 9).
The novelty of the proposed method
The relationship of indicators of fluctuations in heart rate in the low frequencies (LF norm) and high frequency (FTF norm), with the development of discoordination labor is installed for the first time.
Distinctive features of the way
Established prognostic parameters indicators of fluctuations in heart rate in the low frequencies (LF norm) and high frequency (HF norm) in pregnant women at risk of developing DGS 37 of negligently: when values of LF norm equal to 53,9% or less and HF norm equal to 46.1 per cent or more, are forecasted discoordination generic activities with an accuracy of 87.8%.
The method is as follows.
The initial data for calculation of indicators LF norm and HF norm was the electrocardiogram (ECG), which is registered in 6-lead (I, II, III standard, aUR, aVL, aVF) at rest in the supine position, in the morning on an empty stomach, after a 10-minute rest. The duration of the ECG recording was 5 minutes. Dannemoine No. 29/02020300/1987-01 dated 27.07.2001,, firm “Neurosoft”, Ivanovo), intended for cardiac research. The obtained data were expressed as a percentage.
The essence of the proposed method is illustrated by the following examples.
Example 1. Pregnant K., 28 years. Obstetric history burdened. The first pregnancy ended in a medical abortion in the period of 10 weeks, the second - spontaneous miscarriage during pregnancy 8-9 weeks of pregnancy, third and fourth - minibottle. This fifth pregnancy, desirable in marriage. The woman identified as high risk of developing abnormalities of labor activity. He enrolled in the Department of pathology of pregnant women with a diagnosis of Pregnancy 37 weeks. Nephropathy of I degree. The OAS (burdened obstetric anamnesis). Immature cervix.
Survey data by the present method: the estimate of the HRV index LF norm made up 48.2%, lower than the declared parameter, HF norm - 51,8%, which is higher than the stated parameter. Forecasted discoordinated labor. The pregnancy ended in timely delivery, which was complicated by discoordinating labor. He was born full-term baby weighing 3200 g, height 50 cm, ozenna So, 26 years. Gynecological anamnesis burdened. This first pregnancy. History of gynecological diseases notes the menstrual function: menstruation 17 years, irregular, with delays of up to 3-4 months, about which repeatedly surveyed in the gynecology Department, were treated without effect. The woman identified as high risk of developing abnormalities of labor activity. He enrolled in the Department of pathology of pregnant women with a diagnosis of Pregnancy 37 weeks. Polyhydramnios. Burdened gynecological anamnesis. Mature cervix.
Survey data by the present method: the estimate of the HRV index LF norm was 53,9%, HF norm - 46,1%. Forecasted discoordinated labor.
The pregnancy ended in a timely birth at 39 weeks. In birth prevention discoordinating labor was used antispasmodic drugs, with a positive effect discoordinated labor has not developed. He was born full-term baby weighing 3400 g, height 50 cm, with rating on a scale of Apgar 7-8 points. Conclusion: the Outlook for the claimed method was not confirmed in connection with the timely prevention.
Survey data by the present method: the estimate of the HRV index LF norm stood at 64.5%, which is higher than the stated parameters, HF norm - of 35.5%, which is below the stated parameters. Predicted normal family activities.
The pregnancy ended in a timely birth at 40 weeks. Delivery was uneventful. He was born full-term baby weighing 2600 grams and height of 51 cm, with rating on a scale of Apgar 8-9. Conclusion: the prediction by the present method were confirmed - the anomaly of labor has not developed.
In this way were examined 142 pregnant women at risk for the development of ARD. Research data in the table.
The advantages of the proposed method:
1. The possibility od simple in execution, it has high accuracy.
3. Method neuvation.
4. Method objective.
5. The duration of the methodology and calculation of the indicators is 15 minutes.
6. The method does not require expensive equipment.
1. Abramenko centuries of Active management of labour. St. Petersburg: Special literature, 1997.
2. Sidorov I. S. Physiology and pathology of labor activity. - M.: Medpress, 2000. - 318 S.
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4. Kulakov Century. And., Serov Century. N. and other labor Pain relief. - M.: “Triada-X, 1998. - 152 C.
5. Eagles Century. And., Pogorelov I.e., Drucker N. A., Yurovsky, C. L. a Method for predicting discoordination labor. //Official Bulletin “Discoveries. The invention.” - 1991. - №18. - C. 17.//A. S. No. 1648346.
6. Glushko A. A., Fedorov, M. C., Kotov, Y. B., Tumanyan E. E. a Method for predicting anomalies labor before the birth.// Bulletin “Inventions”. - 1999. - No. 22. h 2. - S. 390.// Patent No. 2134418.
7. Ryabikin, C., Sobolev A. B. heart rate Variability. - M.: Publishing house “the Old Co, 1998. - 200 S.
8. Ryabikin, C., Sobolev A. C. Analysis of HRV. //Cardiology. - 1996. - so 36. No. 10, S. 87-97.
9. Variab The Recommendations. //The Bulletin of Arrhythmology. - 1999. No. 11. - S. 53-78.
A method for predicting the development discoordinating labor in pregnant women risk group method of functional diagnostics, characterized in that in women with 37 weeks of gestation identify indicators of fluctuations in heart rate in the low and high frequencies and at low frequencies, equal 53,9% or less, and a high frequency equal to 46.1 per cent or more, predict the development of discoordination labor.
FIELD: medicine, cardiology.
SUBSTANCE: one should register rhythmocardiogram, measure current total power in low-frequency and high-frequency areas of dynamic row of cardiointervals. Evaluation of psychophysiological state should be performed by the value of stress index S calculated due to original mathematical formula by taking into account the power of low-frequency and high-frequency constituents of the range of dynamic row of cardiointervals. In case of standard conditions of measurement - the rest lying at one's back position the value of S stress index should be considered to be equal to 1. The method enables to rapidly and noninvasively detect and range human psychophysiological state.
EFFECT: higher accuracy of evaluation.
2 dwg, 1 ex, 2 tbl
SUBSTANCE: method involves estimating vegetative tonus using cardiointervalography approach and its medication adjustment under cardiointervalography control. The cardiointervalography examination is carried out before applying treatment, in the course of and after the treatment. Each time vegetative tonus increment is estimated on the basis of voltage index. When applying medication adjustment, nootrop group preparations are used that are selected before applying treatment with initial vegetative tonus disorder distinguished by vagotonia or sympathicotonia being taken into account. Preparation or combination of preparations or their doses and application duration is adjusted on basis of vegetative status direction changes obtained from cardiointervalography examination data. The treatment is continued until vegetative status direction change stops towards normotonia.
EFFECT: enhanced effectiveness in selecting individual treatment course.
3 cl, 3 dwg
SUBSTANCE: method involves recording rhythmocardiogram. Then, spectral analysis of RR intervalogram components in frequency bandwidth from 0.04 to 0.4 Hz is carried out and information value Z is determined from formula Z=Ahf/Alf, where Ahf is the maximum of high frequency component in bandwidth from 0.14 to 0.4 Hz, Alf is the minimum of high frequency component in bandwidth from 0.04 to 0.14 Hz. Z value being greater than 45 and lower than 14, persons consuming narcotic drugs are detected. Z value being lower than 14, persons consuming sedative drugs like opium, morphine, heroine are detected. Z value being greater than 45, persons consuming psychostimulating drugs like cocaine, amphetamine, efedrone, sydnocarb are detected.
EFFECT: high reliability of screening study data.
4 cl, 6 dwg
FIELD: medicine, diagnostics.
SUBSTANCE: the method deals with monitoring the difference in signals obtained from N pickup units, where N ≥ 2, ECG, pulse, temperature and analysis of the range and variability of their rhythms, nonlinear chaotic fluctuations during the period of registration. During analysis one should detect the values for fractal dimensions of Hirst's index and informational Fischer's index standardized, correspondingly, by the average value during either nocturnal or diurnal period. One should conclude upon improved body state by the normalization of signals' difference of peridiurnal rhythm, increased fractal dimensions, Hirst's index, decreased standardized informational Fischer's index, and one should conclude upon worse physiological or pathophysiological processes according to the opposite alterations. The method enables to widen functional possibilities during diagnostics.
EFFECT: higher accuracy of diagnostics.
3 dwg, 6 ex
FIELD: medicine; cardiology.
SUBSTANCE: electrocardiogram of patients with arterial hypertension is subject to twenty-four-hours monitoring. Spectral analysis of variability of heart beating is conducted and low-frequency, very low frequency and high frequency wave components of heart beating are selected. Strength of wave components of heart beating is determined as general, day and night ones. Generalized factor W is calculated by original relation. Value of W is used for diagnosing absence or presence of hormone-active hyper-plastic process of adrenal glands.
EFFECT: screening testing at out-patient conditions.
2 ex, 2 tbl
FIELD: medicine; cardiology.
SUBSTANCE: electrocardiogram of patients suffering from arterial hypertension is subject to twenty-four-hours monitoring. Spectral analysis of variability of heart beating is carried out. Very low frequency, low frequency and high frequency wave components are selected. General, day and night strength of wave components of heart beating is determined. Any factor is estimated according to the data taken from the spreadsheet. Generalized factor Z is calculated by original mathematical relation. Value of Z is used for judging on level of influence of hormones of adrenal gland onto pace-maker activity of sinus node.
EFFECT: comfort at usage; higher efficiency at non-invasive application.
2 ex, 2 tbl
FIELD: medicine; functional medicine.
SUBSTANCE: method in based upon remote irradiation of human body with set of super wide-band electromagnet pulses with duration of 0,2-1,0 ns, repetition rate of 0,05-30,0 MHZ and average density of flow of energy at irradiated part of human body being equal or less than 0,2 mcW/cm2. Modulation component of pulse repetition rate is selected from received reflected signal which pulse repetition rate is determined by heart activity, which is used for forming heart beat rate signal. The latter is used additionally for estimating index of stress which value of index of stress is included into transmitted communication message of mobile phone.
EFFECT: prolonged monitoring of functional condition of human.
3 cl, 2 dwg
FIELD: medicine, cardiology.
SUBSTANCE: one should register a rhythmocardiogram, detect spectral values for variability of cardiac rhythm, calculate the value of autonomic index, calculate the value of autonomic tonicity by the following formula: AI/lnTp m sq. sec., where AI - autonomic index, lnTp - total power for the spectrum of variability of cardiac rhythm. At values above 3.1 one should diagnose severe flow of autonomic dystonia syndrome, at values being 3.1-2.2 - moderate flow of the mentioned disease, at values ranged 2.1-1.5 - light flow. The method enables to predict the development of hemodynamic disorders.
EFFECT: higher efficiency and accuracy of diagnostics.
FIELD: medicine; cardiology.
SUBSTANCE: device for processing intervals of electrocardiogram has plate with Q-T (J-T) and R-R scales applied onto the plate. Plate is additionally provided with legs, rod and scale pointer at the end, arrows, and catches disposed at ends of Q-T (J-T) scale, Q-Tc (J-Tc) correlated values curves and Q-Tc (J-Tc) scale related to them. Rod is divided by axis to parts to relate as 1:5 in such a way that shorter part of rod has to be movable leg and longer part has to be the pointer of Q-T (J-T) scale. Pointer takes "0" position of Q-T (J-) scale to rest against left catch when legs close up. Motionless arrow is disposed onto longer part of rod under pointer of Q-T and/or J-T scale at level of "0" position of R-R scale. Slider with lock is mounted onto pointer to move along pointer. Slider is provided with two arrows. Formulas for building curves of Q-Tc (J-Tc) corrected values are given.
EFFECT: higher speed and comfort at processing of electrocardiograms.
3 cl, 8 dwg, 1 tbl
FIELD: medicine, electrocardiography.
SUBSTANCE: the present innovation deals with measuring parameters of electrocardiosignal (ECS) ST-segment and their analysis to detect deviations against the norm. At every step of quantization one should form the readings of first-order differences and modules of first-order differences. One should memorize N of readings for the modules of first-order differences coming after ECS readings that correspond to the onset of cardiocycle. Then it is necessary to sum up memorized values of modules and at every step of quantization one should compare the obtained current sum value with previous one. It is necessary to memorize the greater of them and according to maximal value one should form threshold level to compare current value of modules sum. Time moments when sum value is at first greater and then lower against threshold level one should consider to be, correspondingly the onset and the end of ST-segment. Time segment between the onset and the end of ST-segment should be considered as duration of ECS ST-signal. Device to isolate ECS ST-signal on-line contains a block for forming ECS, a block for primary ECS processing, a quantization block, a block for isolating the point of cardiocycle onset and measurement of its duration, a block to form first-order differences, a block to form modules of first-order differences, a block to memorize readings for the modules of first-order differences, a block to detect the number of summarized readings for the modules of first-order differences, a summarizing block, a block to form a threshold level, a block for comparison and a key device. The innovation enables to isolate ST-segment more reliably for wider class of electrocardiograms at different modifications of QRS-complex form.
EFFECT: higher efficiency.
2 cl, 12 dwg