The contribution of symptomatology and/or uterine activity to the incidence of unscheduled visits.
Home uterine activity monitoring and perinatal nursing support have been shown to be associated with a decrease in preterm births with no increase in the number of unscheduled patient visits. This prospective, randomized multicenter study compared the frequency of unscheduled visits in patients receiving home uterine activity monitoring and perinatal nursing support with that of patients receiving education regarding the detection and reporting of preterm labor symptomatology. The contribution of patient-reported signs and symptoms versus objective uterine activity data to unscheduled visits is assessed. The overall frequency of unscheduled visits was similar in both groups. In the home uterine activity monitoring and perinatal nursing support group, the contributions of uterine activity versus signs and symptoms to the diagnosis of preterm labor were equal, with 36% of patients diagnosed with preterm labor sent to the physician for increased uterine activity and 36% for signs and symptoms. The sensitivity for the group receiving monitoring and nursing support in detecting preterm labor was 93%. The majority of false-positive visits were associated with patient symptoms. These data show that this combination service does not lead to a clinically significant increase in unscheduled visits. Further, the visits resulting from the combination service provide a sensitive predictive method to aid physicians in detecting early labor.
Knuppel
R A
RA
Department of Obstetrics and Gynecology, University of South Florida, Tampa.
Lake
M F
MF
Watson
D L
DL
Welch
R A
RA
Hill
W C
WC
Fleming
A D
AD
Martin
R W
RW
Bentley
D L
DL
Hamer
C
C
Morrison
J C
JC
D002986:Clinical Trials as Topic; D005260:Female; D006699:Home Care Services; D006801:Humans; D008991:Monitoring, Physiologic; D007752:Obstetric Labor, Premature / Q000175:diagnosis / Q000451:nursing / Q000503:physiopathology / Q000517:prevention & control*; D009819:Office Visits / Q000706:statistics & numerical data*; D010353:Patient Education as Topic; D011237:Predictive Value of Tests; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012648:Self Care; D014590:Uterine Contraction / Q000502:physiology*