Martin R W, Gookin K S, Hill W C, Fleming A D, Knuppel R A, Lake M F, Watson D L, Welch R A, Bentley D L, Morrison J C
Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson.
Obstet Gynecol. 1990 Jul;76(1 Suppl):19S-23S.
The relative contribution of uterine activity obtained by home monitoring with a guard ring tocodynamometer compared with seven specific signs and symptoms reported during patient/nurse contact as an aid in detecting preterm labor has not been studied. In this prospective, multicenter study, patients at risk for developing early labor who were randomized to receive home uterine activity monitoring and perinatal nursing support were assessed. The initiator of provider contact (uterine activity detected on routine transmission, patient-perceived signs and symptoms of preterm labor during perinatal nurse contact, or both) resulting in a diagnosis of preterm labor was recorded. Contraction data were then analyzed for an association with preterm labor. There was a strong association of increased uterine activity (four or more contractions per hour) on a repeat monitoring strip with preterm labor (P less than .001). Among patients diagnosed with preterm labor, 31% had increased uterine activity detected on a routine transmission without patient-reported signs and symptoms, compared with 24% who were diagnosed as the result of patient-reported symptoms without increased uterine activity. Daily objective uterine activity data alone have greater incremental value over and above other signs and symptoms as an aid to the physician in diagnosing preterm labor.
与患者/护士接触期间报告的七个特定体征和症状相比，使用护环宫缩压力计进行家庭监测所获得的子宫活动的相对贡献尚未得到研究，这些体征和症状有助于检测早产。在这项前瞻性多中心研究中，对有早产风险且被随机分配接受家庭子宫活动监测和围产期护理支持的患者进行了评估。记录导致早产诊断的医疗服务提供者接触的发起因素（在常规传输中检测到的子宫活动、围产期护士接触期间患者感知到的早产体征和症状，或两者兼有）。然后分析宫缩数据与早产的关联。重复监测条带上子宫活动增加（每小时四次或更多次宫缩）与早产之间存在强烈关联（P小于0.001）。在被诊断为早产的患者中，31%在常规传输中检测到子宫活动增加，而患者未报告体征和症状，相比之下，24%是由于患者报告症状而被诊断为早产，此时子宫活动并未增加。单独的每日客观子宫活动数据在帮助医生诊断早产方面比其他体征和症状具有更大的增量价值。
