Knuppel R A, Lake M F, Watson D L, Welch R A, Hill W C, Fleming A D, Martin R W, Bentley D L, Moenning R K, Morrison J C
Department of Obstetrics and Gynecology, University of South Florida, Tampa.
Obstet Gynecol. 1990 Jul;76(1 Suppl):24S-27S.
In this investigation, 45 women with twin gestations in four centers were randomly assigned to either daily home uterine activity monitoring and perinatal nursing support (19) or an education group (26). Patients in the home uterine activity monitoring and perinatal nursing support group monitored uterine activity twice daily, transmitted the data each day, and had 24 hour-a-day access to nursing support. Education patients were counseled regarding the common signs and symptoms of preterm labor. Both groups had scheduled prenatal visits at least every 2 weeks. Sixteen (62%) of the education group and 14 (74%) of the home uterine activity monitoring and perinatal nursing support group developed preterm labor, values that were not significantly different. Of the monitored group who experienced preterm labor, all 14 were dilated 3 cm or less at diagnosis of the first preterm labor, compared with ten of 16 in the education group (P = .01; one-tailed Fisher test). The mean cervical dilatation at the first preterm labor episode in the group receiving daily monitoring and contact (1.6 cm) was significantly less (P = .01) than that in the education group (2.9 cm). Thus, fewer preterm births were recorded in the home uterine activity monitoring and perinatal nursing support group and significantly fewer patients delivered because of failed tocolysis (P = .03).
在这项研究中，四个中心的45名怀有双胎的女性被随机分为两组，一组为每日家庭子宫活动监测及围产期护理支持组（19人），另一组为教育组（26人）。家庭子宫活动监测及围产期护理支持组的患者每天监测两次子宫活动，每天传输数据，并且可以随时获得全天24小时的护理支持。教育组患者接受了早产常见体征和症状的咨询。两组均至少每2周安排一次产前检查。教育组中有16人（62%）发生早产，家庭子宫活动监测及围产期护理支持组中有14人（74%）发生早产，两组数值无显著差异。在发生早产的监测组中，所有14人在首次诊断早产时宫颈扩张均在3厘米或以下，而教育组的16人中则有10人如此（P = 0.01；单尾Fisher检验）。接受每日监测和联系的组在首次早产发作时的平均宫颈扩张程度（1.6厘米）显著低于（P = 0.01）教育组（2.9厘米）。因此，家庭子宫活动监测及围产期护理支持组记录的早产较少，因宫缩抑制失败而分娩的患者也显著较少（P = 0.03）。
