ArticleActa obstetricia et gynecologica Scandinavica2026
Objective and comprehensive characterization of uterine peristaltic activity throughout the menstrual cycle by means of intracavitary electrohysterography, a cohort study.
Article in Acta obstetricia et gynecologica Scandinavica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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- Objective and comprehensive characterization of uterine peristaltic activity throughout the menstrual cycle by means of intracavitary electrohysterography, a cohort study.Acta obstetricia et gynecologica Scandinavica · 2026Article
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Abstract
introductionThe uterus exhibits dynamic peristaltic activity across the menstrual cycle, playing a critical role in reproductive processes such as sperm transport and embryo implantation. However, current imaging methods to assess this activity provide little information and are limited by subjectivity and lack of sensitivity. A recent pilot study has shown the potential of intracavitary electrohysterography (IC-EHG) to study peristalsis in the uterine fundus. This study aimed to generalize previous results, compare peristalsis in other uterine regions, and study more peristaltic features. MATERIAL AND
methodsThis prospective multicenter cohort study included 40 healthy women with proven fertility. IC-EHG signals were recorded from different uterine sites for 30 min during three menstrual phases: mid-follicular (MF), early luteal (EL), and late luteal (LL) using a custom-designed multipolar catheter. PRIMARY OUTCOMES: contraction frequency (CT/min) and amplitude (μV); secondary outcomes: basal amplitude, contraction time percentage, contractility index and local organization index. Statistical comparisons between phases and regions were performed using Wilcoxon signed-rank tests.
resultsA total of 95 fundal and 90 lower-segment IC-EHG recordings were analyzed. Contraction frequency peaked during the EL phase (fundus: 3.91 CT/min; lower segment: 4.01 CT/min) and was lowest during MF (fundus: 3.28 CT/min, p = 0.042; lower segment: 3.65 CT/min, p = 0.024). Fundal contraction amplitude decreased progressively from MF (16.27 μV) to LL phase (10.56 μV, p < 0.001). Basal amplitude, contraction time percentage and contractility index were also lowest in the LL phase for both uterine regions. Except for frequency, fundus peristaltic activity features were smaller than those of the lower segment, significantly during the MF phase. Local coordination index revealed lower local cell organization in the fundus across all phases, with maximum coordination during EL in both regions (p < 0.01).
conclusionsIC-EHG technique enables objective, reproducible, and quantitative assessment of multiple aspects of uterine peristalsis, revealing distinct regional and cycle-phase-dependent patterns. The decline in most contractile features during the LL phase supports the physiological uterine quiescence required for embryo implantation. The uterine fundus is more active during the MF phase. This study provided reference values for healthy, fertile conditions and could inform further investigation of alterations due to disorders or intervention strategies.
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