title: A randomized comparison of home uterine activity monitoring in the outpatient management of women treated for preterm labor.
abstract: OBJECTIVE
  The aim of the study was to evaluate home uterine activity monitoring as an intervention in reducing the rate of preterm birth among women treated for preterm labor.
  
  
  METHODS
  A total of 186 women were treated in the hospital with magnesium sulfate for preterm labor and were prospectively randomly assigned to study groups; among these, 162 were ultimately eligible for comparison. Eighty-two of these women were assigned to the monitored group and 80 were assigned to an unmonitored control group. Other than monitoring, all women received identical prenatal follow-up, including daily perinatal telephone contact and oral terbutaline therapy. Outcome comparisons were primarily directed toward evaluation of preterm birth at <35 weeks' gestation. Readmissions for recurrent preterm labor and observations lasting <24 hours were evaluated in monitored and unmonitored groups. Compliance with monitoring was also evaluated in the monitored group.
  
  
  RESULTS
  The monitored and control groups were demographically similar. According to a multivariate logistic regression model, women with cervical dilatation of >/=2 cm were 4 times more likely to be delivered at <35 weeks' gestation (P <.05). Gestational ages at delivery were similar in the monitored and control groups. There was no significant difference in the overall rate of preterm delivery at <35 weeks' gestation between the monitored group (10.9%) and the control group (15.0%). The overall rates of delivery at <37 weeks' gestation were high (48.8% and 60.0% for monitored and control groups, respectively), and the difference was not significant. The numbers of women with >/=1 instance of readmission and treatment for recurrent preterm labor were equal in the monitored and control groups. The numbers of women with >/=1 hospital observation lasting <24 hours were not different between the groups. Compliance with monitoring did not significantly differ for women who were delivered at <35 weeks' gestation, women with >/=2 cm cervical dilatation at enrollment, or for African American women.
  
  
  CONCLUSIONS
  A reduction in the likelihood of preterm delivery at <35 weeks' gestation was not further enhanced by the addition of home uterine monitoring to the outpatient management regimens of women treated for preterm labor.
authors: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
authors: H L
authors: HL
authors: Brown
authors: K A
authors: KA
authors: Britton
authors: E J
authors: EJ
authors: Brizendine
authors: A K
authors: AK
authors: Hiett
authors: D
authors: D
authors: Ingram
authors: M A
authors: MA
authors: Turnquest
authors: A M
authors: AM
authors: Golichowski
authors: M P
authors: MP
authors: Abernathy
mesh_terms: D000293:Adolescent; D000328:Adult; D002584:Cervix Uteri / Q000502:physiology; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D016015:Logistic Models; D018670:Monitoring, Ambulatory; D007752:Obstetric Labor, Premature / Q000517:prevention & control* / Q000628:therapy*; D016017:Odds Ratio; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods; D011446:Prospective Studies; D014599:Uterus / Q000502:physiology*