A prospective random trial of home uterine activity monitoring in pregnancies at increased risk of preterm labor. Part II.
Daily uterine activity monitoring has been reported to be helpful in improving the percentage of women with preterm labor eligible for tocolysis, with a corresponding decline in preterm delivery. The first year of our trial of ambulatory tocodynamometry in 157 women at risk of preterm labor did not reveal significant differences in rates of preterm labor and preterm delivery between two groups of women randomly assigned to receive preterm labor education, frequent (5 days/week) telephone contact, and self-palpation of uterine activity (group EP), or to preterm labor education, daily telephone contact, and the Term Guard ambulatory uterine activity monitor (group EM). We report results from the second year (n = 152), yielding a total study population of 309. Forty-three subjects were later excluded, producing 266 subjects who completed the study. Comparison of preterm labor and preterm delivery rates, mean birth weight, and gestational age at delivery revealed no significant differences between the groups for the second year or for the combined data from both years of the study. Interestingly, comparison of all subjects enrolled in year 1 with all those enrolled in year 2 reveals significant decreases in the rates of both preterm labor and preterm delivery. Frequent attention to symptoms and signs of preterm labor, and improved patient and physician education and awareness, may be responsible for this decline in preterm labor and delivery in high-risk pregnancies.
Iams
J D
JD
Department of Obstetrics and Gynecology, Ohio State University, Columbus.
Johnson
F F
FF
O'Shaughnessy
R W
RW
D005260:Female; D006699:Home Care Services; D006801:Humans; D008991:Monitoring, Physiologic / Q000295:instrumentation; D007752:Obstetric Labor, Premature / Q000175:diagnosis* / Q000517:prevention & control; D010173:Palpation; D010353:Patient Education as Topic; D011247:Pregnancy; D011446:Prospective Studies; D011897:Random Allocation; D012648:Self Care; D014590:Uterine Contraction