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Predicting Pre-term Labor?

Gauging Effectiveness of Home Uterine Activity Monitors

By Teri Brown

The concept is brilliantly simple. Devise a method of predicting pre-term labor in high-risk pregnancies so there's a greater chance the labor can be postponed, allowing the mother to carry the baby as close to term as possible. Design the method to be home-based, so the mother can rest in her own surroundings rather than exposing herself and her family to the stress and cost of a long hospital stay. Such a devise could change the face of high-risk pregnancies. But wait – we have such a method. Or do we?

Who would have thought a device designed to catch pre-term labor in high-risk pregnancies would have generated such controversy? But the Home Uterine Activity Monitor (HUAM) system has done just that.

Some women swear by them, while others are concerned the monitors give mothers a false sense of security and make them miss other signs that pre-term labor is imminent. The studies done on the HUAM don't show they are definitely effective in preventing pre-term delivery. Supporters of the HUAM charge the studies are flawed, having been conducted with mostly singleton pregnancies rather than higher order (triplets or more) pregnancies. So how is a mother to make an informed choice with all the conflicting data, opinions and controversy?

Common sense tells us that the HUAM should be effective. The monitor, which is actually a transducer, is strapped around the waist with a belt for one hour twice a day. It is designed to pick up contractions the pregnant woman may not even realize she is having. The device relays information through the phone line to nurses at a central monitoring office who then contact the patient's physician if there is a problem.

Kathleen Osborn, a perinatal nurse coordinator for St. Louis, Mo.-based Biomedical Systems, works in one such central monitoring office. There is no question in her mind that, when used with a complete home monitoring program including education and twice-daily phone conversations with trained nurses, the HUAMs are effective in helping to detect pre-term labor in its early stages.

"It catches the contractions that the patients don't feel," says Osborn. "I think it's a very a useful tool for moms at high risk of pre-term labor. We have caught moms who were entering labor early, and the labor was postponed."

The Biomedical Systems monitoring program detects and documents patients' uterine activity. Experienced obstetrical nurses review uterine contraction activity and conduct maternal and fetal assessments. Because it's done through the telephone, Biomedical Systems can monitor women in remote areas. If you're several hours from a hospital, this may be your best chance of detecting problems early.

Whether their success in detecting pre-term labor is because of the monitors or talking to the patients every day is debatable, but Osborn isn't sure that's the point. "The goal is in detecting the pre-term labor," says Osborn. "Sometimes we can pick up something in our conversations with the patient, something they may think is no big deal."

Putting together those conversations along with the data from the HUAM can alert the nurses who in turn alert a patient's doctor.

Want to see more?

• The Home Stretch: Surviving the Last Trimester With Twins
• I Wish Someone Had Told Me How to Survive the Bedrest Blues
• You're Pregnant With Twins: Now Keep Those Babies in There!
• Talk about it!

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