A randomized comparison of home uterine activity monitoring in the outpatient management of women treated for preterm labor

Brown, Haywood L.; Britton, Kathy; Brizendine, Edward J.; Hiett, Adam K.; Ingram, Denise; Turnquest, Mureena A.; Golichowski, Alan M.; Abernathy, Mary Pell

doi:10.1016/s0002-9378(99)70650-2

Cited by 43 publications

(17 citation statements)

References 17 publications

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“…When looking at their maternal outcomes, the results of these studies are not in line with our findings. Compared with the usual care, these studies report no significant difference in prenatal hospitalizations [14] and mode of delivery [10,11] in RM group. When looking at the neonatal outcomes, some contradictions were found: the study of Corwin et al [9] and Morrison et al [12] states that infants born to monitored women were less likely to be admitted to a NIC compared with women without a RM follow-up program, which are in line with our findings.…”

Section: Discussionmentioning

confidence: 96%

Remote Monitoring of Hypertension Diseases in Pregnancy: A Pilot Study

Lanssens¹,

Vandenberk²,

Smeets³

et al. 2017

JMIR Mhealth Uhealth

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BackgroundAlthough remote monitoring (RM) has proven its added value in various health care domains, little is known about the remote follow-up of pregnant women diagnosed with a gestational hypertensive disorders (GHD).ObjectiveThe aim of this study was to evaluate the added value of a remote follow-up program for pregnant women diagnosed with GHD.MethodsA 1-year retrospective study was performed in the outpatient clinic of a 2nd level prenatal center where pregnant women with GHD received RM or conventional care (CC). Primary study endpoints include number of prenatal visits and admissions to the prenatal observation ward. Secondary outcomes include gestational outcome, mode of delivery, neonatal outcome, and admission to neonatal intensive care (NIC). Differences in continuous and categorical variables in maternal demographics and characteristics were tested using Unpaired Student’s two sampled t test or Mann-Whitney U test and the chi-square test. Both a univariate and multivariate analysis were performed for analyzing prenatal follow-up and gestational outcomes. All statistical analyses were done at nominal level, Cronbach alpha=.05.ResultsOf the 166 patients diagnosed with GHD, 53 received RM and 113 CC. After excluding 5 patients in the RM group and 15 in the CC group because of the missing data, 48 patients in RM group and 98 in CC group were taken into final analysis. The RM group had more women diagnosed with gestational hypertension, but less with preeclampsia when compared with CC (81.25% vs 42.86% and 14.58% vs 43.87%). Compared with CC, univariate analysis in RM showed less induction, more spontaneous labors, and less maternal and neonatal hospitalizations (48.98% vs 25.00%; 31.63% vs 60.42%; 74.49% vs 56.25%; and 27.55% vs 10.42%). This was also true in multivariate analysis, except for hospitalizations.ConclusionsAn RM follow-up of women with GHD is a promising tool in the prenatal care. It opens the perspectives to reverse the current evolution of antenatal interventions leading to more interventions and as such to ever increasing medicalized antenatal care.

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Section: Discussionmentioning

confidence: 96%

Remote Monitoring of Hypertension Diseases in Pregnancy: A Pilot Study

Lanssens¹,

Vandenberk²,

Smeets³

et al. 2017

JMIR Mhealth Uhealth

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“…472 The review of home uterine activity monitoring included three trials (n = 618). [473][474][475] Further details of the review can be found in Appendix 6, Table 125. The overall quality of these studies, shown in Figure 143, was poor with only one trial considered to be of good quality.…”

Section: Home Uterine Monitoringmentioning

confidence: 99%

Screening to prevent spontaneous preterm birth: systematic reviews of accuracy and effectiveness literature with economic modelling

Honest

Ca²,

Durée³

et al. 2009

Health Technol Assess

185

146

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For primary prevention, an effective, affordable and safe intervention applied to all mothers without preceding testing is likely to be the most cost-effective approach in asymptomatic women in early pregnancy. For secondary prevention among women at risk of preterm labour in later pregnancy, a management strategy based on the results of testing is likely to be more cost-effective. Implementation of a treat-all strategy with simple interventions, such as fish oils, would be premature for asymptomatic women. Universal provision of high-quality ultrasound machines in labour wards is more strongly indicated for predicting spontaneous preterm birth among symptomatic women than direct management, although staffing issues and the feasibility and acceptability to mothers and health providers of such strategies need to be explored. Further research should include investigations of low-cost and effective tests and treatments to reduce and delay spontaneous preterm birth and reduce the risk of perinatal mortality arising from preterm birth.

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“…Among monitoring women, pregnancy prolongation, gestational age at birth, and number delivering <37 weeks compared to control patients were significantly improved (p<.011). Brown et al, (1999) studied 86 women who were assigned to monitoring compared to 80 in an unmonitored group following effective acute tocolysis. Unfortunately, the number needed to show a significant difference in preterm delivery was 438 and only 162 were enrolled over a 7-year period.…”

Section: Results Of Tertiary Contraction Monitoringmentioning

confidence: 99%

“…(Morrison et al, 2001;Brown et al, 1999) This translated into a pregnancy prolongation of 7.8 weeks in the monitored group versus 4.4 weeks in the control group. Two studies reported NICU rates of admission (Smith et al, 1994;Brown et al, 1999) and the pooled data reveals a 7.2% NICU admission rate for monitored patients versus 36.2% among the infants of control women.…”

Section: Contraction Monitoring: Pooled Resultsmentioning

confidence: 99%