National Institute of Child Health and Human Development
Maternal Fetal Medicine Units Network

MFMU Network A Prospective Study of
Home Uterine Activity Monitoring (HUAM)

Related Publications & Presentations

Objective

To compare the frequency and pattern of uterine contractions in patients who have a spontaneous preterm delivery with patients who deliver at term. To evaluate predictive value of uterine activity as measured by a home contraction monitor and other screening tests for spontaneous preterm delivery.

Conclusion

Although risk of preterm birth less than 37 weeks rises with increased uterine contraction frequency (UCF), UCF measured between 24 and 36 weeks is a poor test to predict birth less than 37 weeks.

Clinical Centers

Magee Womens, Tennessee, USC, Alabama, Wayne State, Cincinnati Oklahoma, Bowman Gray, Chicago, Ohio State, South Carolina

Major Eligibility Criteria

• Registering for prenatal care prior to 23 weeks gestation
• Telephone in home
• Informed consent

Sample Size

• Goal = 300 evaluable singleton patients
• 230-250 singleton pregnancies with prior preterm birth or second trimester vaginal bleeding who satisfy minimum monitoring compliance criteria
• 50-70 low risk patients who satisfy minimum monitoring compliance criteria
• Twin pregnancies enrolled without restrictions

Scheduled Evaluations/Data Collection

• Visit 1/3/5 (23/28/32 weeks):
• Questionnaire: demographic data, substance use, medical and ob factors, anthropometrics
• Cervical exam
• Ultrasound for cervical parameters: length dilation, station, position, consistency, membranes
• Specimen collection: fetal fibronectin, gram stain for bacterial vaginosis, vaginal pH and KOH for yeast
• Serum collection
• Visit 2/4/6 (26/30/34 weeks):
• Specimen collection: fetal fibronectin only
• Psychosocial questionnaire (visit 2 only)
• HUAM:
• Three times a week at 24, 25, 26 and 27 weeks gestation
• Daily beginning at 28 weeks through 36 weeks 6 days
• Three time blocks: 04:00-11:59, 12:00-19:59; 20:00-3:59
• Labor and Delivery:
• Maternal and neonatal outcome

Outcome Measures

• Primary:
• Hourly contraction rate, by gestational age
• Secondary:
• Contraction pattern for five days preceding preterm birth and each episode of preterm labor
• Frequency of preterm labor symptoms
• Self reported contraction frequency
• Spontaneous preterm delivery (< 37 weeks, < 36 weeks, < 35 weeks, < 32 weeks)

Timetable (as of 5/96)

• Recruitment: 05/94-02/96
• Data Collection: 05/94-09/96
• Closeout/Final Analysis: 09/96-05/97