Predicting preterm labor

Predicting Preterm Labor – Gauging Effectiveness of Home Uterine Activity Monitors

Predicting preterm labor in advance is quite important for your pregnancy. Check out this article to get detailed information.

The concept is brilliantly simple. Devise a method of predicting preterm 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 preterm labor in high-risk pregnancies would have generated such controversy? But the Home Uterine Activity Monitor (HUAM) system has done just that.

You can learn about pregnancy stages and get week by week pregnancy information in our website.

An Important Decision

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 preterm labor is imminent. The studies done on the HUAM don’t show they are definitely effective in preventing preterm 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.

Danielle N., a perinatal nurse coordinator, 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 preterm labor in its early stages.

“It catches the contractions that the patients don’t feel,” says Danielle. “I think it’s a very a useful tool for moms at high risk of preterm labor. We have caught moms who were entering labor early, and the labor was postponed.”

Check our another article about postponed labor : What Happens in Case of Delayed Birth?

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 preterm labor is because of the monitors or talking to the patients every day is debatable, but Danielle isn’t sure that’s the point. “The goal is in predicting preterm labor,” says Danielle. “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.

What about your ideas? Please share your thoughts with us in the comments section.

Let It Go

For Pamela Mason of Westerville, Ohio, using the monitor gave her a peace of mind she wouldn’t have had otherwise. After going into preterm labor at 27 weeks, she used a HUAM for the rest of her pregnancy.

“I believe the use of the HUAM predicted when I needed to get to a doctor or hospital for care to stop preterm labor,” says Mason. For Craig, her ability to stay home made all the difference in an already high-stress situation.

“Long hospital stays are depressing, and I was more comfortable and able to relax at home,” says Mason, who delivered a healthy baby at 35 1/2 weeks. “Because of the HUAM and the 24-hour nursing staff available to me in conjunction with it, my doctors allowed me to stay at home. I had several hospital visits and overnight stays during my bed rest, but if it were not for my monitor, I would have remained in the hospital for the duration of the pregnancy.”

Judy Baldwin of Southfield, Michigan, would unreservedly recommend the HUAM to other mothers with high-risk pregnancies. “As a high-risk bedridden Mom, I was scared for my babies. I am also one who hates calling doctors because I always felt like I was ‘bothering’ them, especially after hours,” says Baldwin. “Having the nurses available 24 hours a day and knowing if I felt like something was wrong, all I had to do was monitor was constant reassurance.”

For Baldwin, it was the combination of actual monitoring and interaction with a medical professional that makes HUAM so valuable.

That is exactly what concerns Grace H., an expert in Portland, Ore. “I think that, too often, the monitors can actually increase a woman’s anxiety,” says Grace. “There are far better indications of preterm labor than the HUAMs.”

To learn about managing stress during pregnancy : Managing Stress During Pregnancy

Reasons of Doubts

Grace believes the Transvaginal Ultrasound is a more consistent predictor than contractions at predicting preterm labor, as is the Fetal Fibronectin (FFN) test. “If a woman comes in with preterm contractions and we find by the Transvaginal Ultrasound that her cervix is normal and the FFN is negative, there is a less than 1 percent chance that she’s going into preterm labor,” says Grace. “We don’t have to send her home to wait on pins and needles for the next monitoring session.”

One study led by researchers from Ohio State University suggests that HUAMs have no value in actually predicting preterm labor. This study was published in the January 2002 New England Journal of Medicine.

There is added emphasis on the system’s usefulness because of the cost of HUAMs, which can be as high as $100 a day. But Danielle, the perinatal nurse coordinator, believes the HUAMs method and the nursing support that goes with it is very cost effective, especially when compared to the cost of one day in the hospital or the even higher cost of the Neonatal Intensive Care Unit.

“I think we figured once that one day in the NICU would cover 41 days of using an HUAM with 24-hour support,” says Danielle.

To the mother experiencing a high-risk pregnancy, there are no easy answers. Clearly, education is needed to make an informed decision, but in the end, it may just come down to personal choice. Would you rest easier with an HUAM system in place? Or would that merely create more anxiety? At any rate, HUAMs are here to stay, whether or not the controversy surrounding them subsides.

Our articles are prepared to give advice. Always consult your doctor first for any problems and exact information.

The names of the people mentioned in the article have been changed for security reasons and to protect privacy.

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