Multicenter randomized clinical trial of home uterine activity monitoring for detection of preterm labor

Article Abstract:

Preterm delivery is the main cause of complications and death associated with childbirth in the US. However, it is often difficult for women to tell when their contractions have progressed sufficiently to require urgent medical care. Several devices have been developed for home monitoring of uterine activity. To evaluate one such device, the Genesis System, a prospective, controlled study was carried out at three medical centers. Patients at risk for preterm labor were randomly assigned to the monitored (198 women) or the unmonitored (179) group. All patients received similar obstetrical care and education concerning the risks of preterm labor and the signs of its onset. Those in the monitoring group received instructions on the monitoring device and were told to use it for one hour twice daily each day beginning at 24 weeks' gestation or upon enrollment, and continuing to 37 weeks or delivery. Results showed that the incidence of preterm labor was similar for the two groups (24.7 percent of monitored patients, 24.4 percent of unmonitored patients), which occurred at an average gestational age of 32.9 weeks. The extent of cervical dilatation at the time preterm labor was diagnosed was recorded for 77 of the 82 women with preterm labor. This value was significantly lower (less dilated) for women in the monitored group (1.4 centimeters) compared with unmonitored group (2.5 cm). Slightly more than 73 percent of the monitored women had their condition diagnosed before cervical dilatation had reached 2 cm, compared with 27.5 percent in the unmonitored group. The neonatal outcome was also better in the monitored group; birth weights were higher, infants spent less time in the neonatal intensive care unit, and fewer babies needed oxygen therapy and mechanical ventilation. The study, which involved a medically and sociodemographically diverse population, shows that a home monitoring device can help patients detect preterm labor earlier, allowing for more prompt treatment to prevent preterm delivery. (Consumer Summary produced by Reliance Medical Information, Inc.)

Product/Service Evaluation, Diagnosis, Medical tests, Uterus, Pregnant, Pregnant uterus, Genesis System (Medical instrument)

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A metaanalysis of home uterine activity monitoring

Article Abstract:

A meta-analysis of studies on the effectiveness of home uterine activity monitoring (HUAM) reveals that it has greater benefits than previously thought. Researchers reviewed the results of six large studies of HUAM which were included in a government task force recommendation that stated home monitoring was ineffective. HUAM is used to identify preterm labor so it can be stopped before preterm delivery occurs. The meta-analysis found that HUAM may decrease the risk of preterm delivery and increase average birth weight. The findings of this meta-analysis differed quantitatively from those of the task force because the researchers assigned more weight to larger and better controlled studies. The task force reviewed the studies qualitatively, which minimized the benefits of HUAM.

Management, Labor (Obstetrics), Home care

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Multicenter randomized clinical trial of home uterine activity monitoring: pregnancy outcomes for all women randomized

Article Abstract:

Home uterine activity monitoring may be more effective in detecting preterm labor, allowing preventive treatment to be given, than intensive prenatal nursing care. Researchers compared the effectiveness of twice a day home uterine activity monitoring to high-risk prenatal nursing care in 339 women with a high risk for preterm labor and delivery. Use of home uterine activity monitoring was associated with longer pregnancies, fewer preterm deliveries, higher birth weights, and fewer admissions to newborn intensive care. The reduction in intensive care use could offset the cost of using home uterine activity monitors.

Prevention, Prenatal care, Self-care, Health, Self care (Health), Patient monitoring, Physiologic monitoring

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