Has the Use of Home Monitors, Fetal Fibronectin, and Measurement of Cervical Length Helped Predict Labor and/or Prevent Preterm Delivery in Twins?
- 1 March 1998
- journal article
- review article
- Published by Wolters Kluwer Health in Clinical Obstetrics and Gynecology
- Vol. 41 (1) , 95-102
- https://doi.org/10.1097/00003081-199803000-00015
Abstract
Home monitoring accurately detects contractions, and thus is useful in predicting preterm labor. Appropriate physician action is necessary to significantly prolong pregnancy even in the presence of evidence of excessive contractions. Despite conflicting studies, the majority of evidence heavily favors the use of monitoring as part of a comprehensive preterm birth prevention program. Indeed, monitoring has greater clinical utility in twin gestations because of the recognized propensity for preterm labor. Fetal fibronectin is one of the most sensitive and specific markers for preterm labor and subsequent early delivery presently available. It appears to be equally effective in multifetal gestations compared with singleton gestations, but intervention trials are needed to substantiate its clinical effectiveness. Cervical status monitoring by ultrasound correlates inversely with preterm labor, but studies in twin gestation are currently lacking. Other markers, such as salivary estriol for preterm labor, have yet to be assessed as predictors of preterm labor among multifetal gestations.Keywords
This publication has 16 references indexed in Scilit:
- The preterm prediction study: Risk factors in twin gestationsAmerican Journal of Obstetrics and Gynecology, 1996
- A metaanalysis of home uterine activity monitoringAmerican Journal of Obstetrics and Gynecology, 1995
- A multicenter randomized controlled trial of home uterine monitoring: Active versus sham deviceAmerican Journal of Obstetrics and Gynecology, 1995
- Cervical examination and tocodynamometry at 28 weeks' gestation: Prediction of spontaneous preterm birthAmerican Journal of Obstetrics and Gynecology, 1995
- The irritable uterus: A risk factor for preterm birth?American Journal of Obstetrics and Gynecology, 1995
- The Economic Impact of Multiple-Gestation Pregnancies and the Contribution of Assisted-Reproduction Techniques to Their IncidenceNew England Journal of Medicine, 1994
- Risks of antepartum cervical examination in multifetal gestationsAmerican Journal of Obstetrics and Gynecology, 1993
- Fetal Fibronectin in Cervical and Vaginal Secretions as a Predictor of Preterm DeliveryNew England Journal of Medicine, 1991
- Prevention of preterm birth in high-risk patients: The role of education and provider contact versus home uterine monitoringAmerican Journal of Obstetrics and Gynecology, 1991
- Cost effectiveness of ambulatory uterine activity monitoringInternational Journal of Gynecology & Obstetrics, 1989