Current status of home uterine activity monitoring. 2003

John C Morrison, and Suneet P Chauhan
Department of Obstetrics and Gynecology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216-4505, USA. jmorrison@ob-gyn.umsmed.edu

A comprehensive evidence-based review of the clinical data leads to the conclusion that if patients at high risk for preterm birth (eg, prior preterm birth because of preterm labor, twins and higher-order multiple gestation, women who have preterm labor during the current pregnancy tocolyzed effectively) use the comprehensive system of HUAM correctly (ie, daily nursing care and twice-daily monitoring) with appropriate alarm rates and sensitive monitors, the incidence of early diagnosis of preterm labor, effective prolongation of pregnancy with fewer preterm births, and a reduction in neonatal morbidity is always demonstrated when the study group is compared with a control group consisting of women receiving standard care available to obstetricians in the United States. The authors expect that there will always be arguments regarding whether the monitor or the nurse contributes most to preterm birth reduction. Even when the alerts of detected contractions or patient-reported symptoms are sounded, the issue of prompt and effective medical intervention will always be hotly debated. The appropriate research design that tests HUAM while allowing various diagnostic and treatment modalities that physicians employ around the United States must be individualized. Physicians must make the decision, based on the evidence, regarding whether or not this system would benefit their patients. While investigators argue about research designs and statistical analyses, physicians simply want the best outcomes for their patients, which is what women and the whole of society also want. Based on the available evidence, it is clear that when the comprehensive system of HUAM is used appropriately in the right patients, everyone benefits.

UI MeSH Term Description Entries
D007752 Obstetric Labor, Premature Onset of OBSTETRIC LABOR before term (TERM BIRTH) but usually after the FETUS has become viable. In humans, it occurs sometime during the 29th through 38th week of PREGNANCY. TOCOLYSIS inhibits premature labor and can prevent the BIRTH of premature infants (INFANT, PREMATURE). Preterm Labor,Labor, Premature,Premature Labor,Premature Obstetric Labor,Labor, Premature Obstetric,Labor, Preterm
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D005260 Female Females
D006699 Home Care Services Community health and NURSING SERVICES providing coordinated multiple services to the patient at the patient's homes. These home-care services are provided by a visiting nurse, home health agencies, HOSPITALS, or organized community groups using professional staff for care delivery. It differs from HOME NURSING which is provided by non-professionals. Domiciliary Care,Home Health Care,Care Services, Home,Home Care,Services, Home Care,Care, Domiciliary,Care, Home,Home Care Service,Service, Home Care
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014590 Uterine Contraction Contraction of the UTERINE MUSCLE. Myometrial Contraction,Contraction, Myometrial,Contraction, Uterine,Contractions, Myometrial,Contractions, Uterine,Myometrial Contractions,Uterine Contractions
D015148 Cardiotocography Monitoring of FETAL HEART frequency before birth in order to assess impending prematurity in relation to the pattern or intensity of antepartum UTERINE CONTRACTION. CTG, Antepartum,Cardiotocogram,Electronic Fetal Monitoring,External Cardiotocography,External Fetal Monitoring,Internal Cardiotocography,Internal Fetal Monitoring,Antepartum CTG,Cardiotocograms,Cardiotocography, External,Cardiotocography, Internal,Fetal Monitoring, Electronic,Fetal Monitoring, External,Fetal Monitoring, Internal,Monitoring, Electronic Fetal,Monitoring, External Fetal,Monitoring, Internal Fetal
D018590 Uterine Monitoring Measurement or recording of contraction activity of the uterine muscle. It is used to determine progress of LABOR, OBSTETRIC and assess status of pregnancy. It is also used in conjunction with FETAL MONITORING to determine fetal response to stress of maternal uterine contractions. Tocodynamometry,Tocography,Tocograms,Monitoring, Uterine,Monitorings, Uterine,Tocogram,Uterine Monitorings

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