Home uterine activity monitoring: an evidence review of its utility in multiple gestations

Abstract

Objective: To examine the medical evidence regarding the application of home uterine activity monitoring for multiple gestations.

Study design: All of the published peer-reviewed articles on the topic were assembled and assigned a level of evidence based on research design. The search uncovered 9 articles, including 3 Level I randomized, controlled trials; 1 level II matched cohort trial; and 5 level III case series.

Results: The first 5 trials all showed promising results for home uterine activity monitoring applied to multiple gestations. Ultimately, however, 14 years after the introduction of home uterine activity monitoring, the largest randomized, controlled trial was published, and it demonstrated that pregnancy outcomes were identical for patients with home uterine activity monitoring and patients receiving weekly calls from a nurse. A subsequent National Institute of Child Health and Human Development published trial may provide a clue as to why the large, randomized, controlled trial demonstrated no difference.

Conclusion: Contractions in multiple gestations are not predictive of preterm birth.