Preterm birth is a major cause of perinatal illness and death. Increased uterine contractions may be a sign of preterm labour, and treatment can inhibit the onset of labour, or prolong the pregnancy, giving time for treatment to improve the baby’s breathing at birth. However, many women do not recognise these contractions in time for treatment. If such pregnant women could be identified, and could use a monitoring device at home to send relevant clinical to the doctors and midwives caring for them, it might be possible to detect and treat.
We identified 15 randomised studies (involving 6008 women) but only 13 contributed . Most of the studies compared women who had been instructed in how to examine themselves and check for signs of premature labour with women given the same instructions but also given a uterine activity monitor. In some studies both groups used a monitor but one group had a ‘sham’ monitor that did not actually send the readings to the women’s healthcare providers.
Using an active monitor at home made very little difference to many of the outcomes for mother or baby, although not all studies measured all outcomes. Women using home uterine monitoring were no less likely to experience preterm birth (at less than 37, or less than 32 weeks of pregnancy). Our results suggest that women using home uterine monitoring were less likely to experience preterm birth at less than 34 weeks but when we restricted our analyses to high quality studies, there was no longer a significant difference between groups. Babies born to women using the monitor were less likely to be admitted to special care baby unit (neonatal ) but there were no fewer deaths. Women using the device were more likely to make an unscheduled antenatal visit, but the number of antenatal hospital admissions did not differ. Women using home uterine monitoring appeared to be more likely to receive tocolysis but when we restricted the results to high quality studies, the difference was no longer significant. We found no to assess maternal anxiety or acceptability, although one large reported low compliance with the use of . In some of the studies, women in the monitoring groups had more contact with midwives or maternity nurses, but it is impossible to tell what effect this might have had.
This record should be cited as:
Urquhart C, Currell R, Harlow F, Callow L. Home uterine monitoring for detecting preterm labour. Cochrane Database of Systematic Reviews 2015, Issue 1. Art. No.: CD006172. DOI: 10.1002/14651858.CD006172.pub3