Evaluation of the cost-effectiveness of home monitoring of uterine contractions

Article Abstract:

Preterm birth, delivery of a fetus before the 37th completed week of pregnancy, is associated with short- and long-term infant complications and death. The high cost of caring for a surviving premature infant in a neonatal intensive care unit exceeds $5 billion a year. A new home monitoring system can measure uterine activity in pregnant women with a great deal of accuracy. Programs aimed at reducing the incidence of preterm birth utilize the home monitoring system in conjunction with daily contact with perinatal nurses. Uterine activity is recorded periodically throughout the day and transmitted via the telephone to be interpreted by the nurses. In patients at risk for preterm delivery, this type of prevention program is able to diagnose preterm labor early, which allows effective management strategies to be initiated before delivery is unavoidable. An insurance carrier in Hawaii conducted a study to determine if a home monitoring device known as an ambulatory tocodynamometer is useful in reducing the cost of preterm labor and delivery. Of the 79 patients, who were on the monitor for a combined total of 3,189 days, 36 did not develop preterm labor. The cost of daily monitoring represented a loss to the insurance carrier of $118,800, or $3,300 for each patient who did not have preterm labor. When home monitoring detects labor early, agents used to arrest preterm labor are more effective and therefore more likely to prolong pregnancy. For the 43 patients diagnosed with preterm labor, the savings to the insurance company was $24,000 per patient or a total of $1,032,000. When the total cost was estimated for the entire group of high-risk patients, the final cost savings of home monitoring to the insurance carrier was $913,200 ($11,500 per patient). Therefore, a home monitoring system that accurately measures the uterine activity of high-risk patients can reduce the overall cost of preterm delivery by allowing early care and treatment of preterm labor. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Economic aspects, Finance, Health insurance, Medical care, Cost of, Health care costs, Patient monitoring, Physiologic monitoring

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Oncofetal fibronectin in patients with false labor as a predictor of preterm delivery

Article Abstract:

The presence of oncofetal fibronectin in cervicovaginal fluid may indicate that a pregnant women in false labor will deliver her baby prematurely. Oncofetal fibronectin is a protein that is present in amniotic fluid, placental tissue and different types of malignant cells. Cervicovaginal fluid samples were taken from 28 women between 24 and 36 weeks pregnant who were experiencing false labor. Fourteen samples were positive for oncofetal fibronectin and 14 were negative. Nine of the women who were positive for oncofetal fibronectin gave birth prematurely, compared with one woman who was negative for oncofetal fibronectin. It is sometimes difficult to distinguish false labor from true labor. This distinction is particularly important in women who are experiencing preterm labor. Preterm delivery is one of the most frequent causes of complications and death in newborns.

Physiological aspects, Fibronectins, Premature birth, CEA (Oncology), Carcinoembryonic antigen

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