Management of preterm labor patients at home: does daily uterine activity monitoring and nursing support make a difference?
Daily home uterine activity monitoring and perinatal nursing support were compared with standard care in managing patients with recurrent preterm labor during the current pregnancy in an effort to reduce preterm birth. Sixty-seven successfully treated preterm labor patients were randomly assigned in this multicenter study to daily home uterine activity monitoring and perinatal nursing support or to a standard-care group. Recurrent preterm labor occurred in 15 (45%) of monitored patients and 19 (56%) of standard-care patients. The risk of preterm birth (before 37 weeks) for patients with recurrent preterm labor was significantly reduced (P = .025) in the monitored group (seven, or 47%) compared with the standard-care group (16, or 84%). The relative risk of delivering because of failed tocolysis was 2.8 for the standard-care group versus the monitored group. There were no patients in the monitored group who delivered at the first recurrence of preterm labor for failed tocolysis. The data suggest that home uterine activity monitoring and perinatal nursing support are helpful in achieving term birth through earlier detection and treatment of recurrent preterm labor.
Watson
D L
DL
Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan.
Welch
R A
RA
Mariona
F G
FG
Lake
M F
MF
Knuppel
R A
RA
Martin
R W
RW
Johnson
C
C
Bentley
D L
DL
Hill
W C
WC
Fleming
A D
AD
D000328:Adult; D005260:Female; D006699:Home Care Services; D006801:Humans; D015994:Incidence; D008991:Monitoring, Physiologic; D007752:Obstetric Labor, Premature / Q000453:epidemiology / Q000451:nursing / Q000503:physiopathology / Q000517:prevention & control*; D011247:Pregnancy; D012008:Recurrence; D012307:Risk Factors; D014590:Uterine Contraction / Q000502:physiology*