The contributions of the nurse and the machine in home uterine activity monitoring systems

Article Abstract:

Programs to prevent premature births consist of broad-based patient and professional education, and involve both pregnant women and their health care providers. The monitoring of uterine activity (contractions) at home combined with daily telephone contact between pregnant women and nurses is intended for selected patients who are at high risk of premature labor. Although the combined program is effective, the relative contribution of electronic monitoring versus nursing contact is not clear. One study showed that the combined program decreased the incidence of premature births. However, there was no difference in the incidence of premature births between women who received intensive preterm labor education, had daily nursing contact, and used uterine monitors, and women who received the same education, had daily nursing contact, and practiced twice-daily uterine palpation (feeling the uterus through the abdominal wall to detect contractions). On the basis of this study and similar research, the American College of Obstetricians and Gynecologists (ACOG) does not currently recommend the routine clinical use of mechanical devices to monitor uterine activity at home. The ACOG committee feels that further studies are needed before widespread home use of monitors is implemented. A program involving nursing supervision, uterine monitoring, and pregnant women is described. The findings demonstrate that the combined use of technology and nursing expertise for assessing patients' symptoms increased the reliability and accuracy of recognizing premature labor. The social support provided by the nurses is an additional factor that helps to reduce the incidence of premature labor among high-risk pregnant women. Future research, public policy issues, and the need to expand nurse-patient interaction into the home are discussed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Cases, Services, Equipment and supplies, Prevention, Technology application, Labor (Obstetrics), Premature birth, Pregnancy, Complications of, Pregnancy complications, Home care services, Obstetrical nursing

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Monitoring the ovulation induction cycle

Article Abstract:

The ovulation induction (OI) cycle may be monitored using transvaginal sonography and by measuring urinary luteinizing hormone (LH). Clomiphene citrate and gonadotropin, used in conjunction with OI, may be given in small doses initially and increased after a failed fertility cycle. Ultrasound may be used in the first days of the menstrual cycle to see whether residual ovarian cysts exist; if cysts are present, OI may be deferred for a month. Basal body temperature and urinary LH kits may help patients determine the onset of ovulation for purposes of timing of intercourse or insemination. The urinary LH surge kits may be more expensive, but may be useful for women who need more precise timing for insemination. Ultrasound determination of follicle size may be a better monitoring tool for gonadotropin cycles than blood estradiol levels. Endometrial thickness greater than eight millimeters may be associated with better pregnancy outcome in OI, even when follicles are not fully mature.

Care and treatment, Panel Discussion, Gonadotropin, Gonadotropins, Infertility, Ovulation, Clomiphene

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Should phosphodiesterase 5 selective inhibitors be used for uterine relaxation?

Article Abstract:

Sildenafil citrate, which is a phosphodiesterase 5-selective inhibitor, is used successfully in treating erectile dysfunction. It is suggested that no clinical trial using sildenafil to promote uteriine relaxation should be initiated based on the currently available data.

Drug therapy, Impotence, Sildenafil, Medical condition overview

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