Hill W C, Fleming A D, Martin R W, Hamer C, Knuppel R A, Lake M F, Watson D L, Welch R A, Bentley D L, Gookin K S
Department of Obstetrics and Gynecology, Creighton University, Omaha, Nebraska.
Obstet Gynecol. 1990 Jul;76(1 Suppl):13S-18S.
The value of home uterine activity monitoring plus perinatal nursing support in the prevention of preterm birth among high-risk patients has been demonstrated by several studies. Other reports with less stringent guidelines and less intensive nursing contact have questioned the contribution of home uterine activity monitoring and perinatal nursing support to a preterm birth prevention program. In this large, prospective, randomized multicenter study, patients were assigned to receive either daily monitoring and nursing contact or a preterm birth prevention program including intensive education and more frequent prenatal visits. Among the monitored patients, there was a significant increase in early detection of preterm labor (2 cm or less), successful tocolysis, and prolongation of pregnancy to term. Thirty-one percent of these diagnoses of preterm labor resulted from evaluation of increased uterine activity without associated patient-perceived symptoms. We conclude that a program of daily uterine activity monitoring and perinatal nursing support results in earlier diagnosis of preterm labor and subsequently more effective tocolysis.
多项研究已证实，家庭子宫活动监测加围产期护理支持在预防高危患者早产方面具有价值。其他一些指南不太严格且护理接触不太密集的报告，对家庭子宫活动监测和围产期护理支持对早产预防计划的贡献提出了质疑。在这项大型、前瞻性、随机多中心研究中，患者被分配接受每日监测和护理接触，或接受包括强化教育和更频繁产前检查的早产预防计划。在接受监测的患者中，早产（宫颈扩张2厘米或以下）的早期检测、成功的宫缩抑制以及妊娠延长至足月均有显著增加。这些早产诊断中有31%是在子宫活动增加但患者无相关自觉症状的情况下评估得出的。我们得出结论，每日子宫活动监测和围产期护理支持计划可导致早产的早期诊断，进而实现更有效的宫缩抑制。
