Home uterine activity monitoring has been described as an effective means of detecting uterine contractions, but controversy exists whether it is home uterine activity monitoring or increased nursing support in conjunction with it that contributes to earlier detection of
preterm labor. In this study 377 women at risk for
preterm labor from three centers were prospectively, randomly assigned to high-risk
prenatal care alone (not monitored) or to the same care with twice-daily home uterine activity monitoring without increased nursing support (monitored). The two groups were medically and demographically similar at entry into the study. Routine visits, nonroutine visits, and gestational age at diagnosis of
preterm labor were similar in both groups.
Preterm labor occurred in 41 of 198 monitored and 39 of 179 not monitored patients. Mean cervical dilatation was 1.4 cm in 41 monitored compared with 2.5 cm for 37 not monitored (p = 0.0006); 73.1% of monitored and 27.5% of not monitored had
preterm labor detected before 2 cm dilatation (p = 0.00009). Neonatal outcome of singleton pregnancies showed greater
birth weight, fewer days in the neonatal intensive care unit, and fewer babies requiring
oxygen therapy and
mechanical ventilation in the monitored group. The better outcomes are probably due to the increased likelihood of diagnosis of
preterm labor before advanced cervical dilatation with home uterine activity monitoring, thus providing the clinician with a better chance to initiate
tocolytic therapy directed at improving pregnancy outcome.