Description of Diagnostic Method

Preterm birth is a leading cause of perinatal morbidity and mortality in the United States. The problem for clinicians has been to diagnose preterm labor and begin treatment with tocolytic agents early enough to maximize the potential for success, but to avoid making the diagnosis of preterm labor too often and thus overtreating with potentially dangerous drugs. HUAM was developed to help patients and physicians detect preterm labor in its early stages. The FDA has approved several HUAM devices. HUAM is not recommended for patients who are unwilling to follow treatment protocols regarding daily use of the monitors and contact with providers.

Summary

With regard to home uterine activity monitoring (HUAM), the ICSI Technology Assessment Committee finds that:

1. Home uterine activity monitoring continues to be a safe procedure and several HUAM devices have been approved by the FDA.
   
2. The effectiveness of HUAM in improving morbidity and/or mortality remains in question (Conclusion Grade III). Additional evidence is needed to determine its usefulness for patients with multiple gestations, patients with a history of preterm birth, and patients diagnosed with preterm labor in their current pregnancy (in lieu of hospitalization). The existing randomized controlled trials have included different "control" groups and have been designed to address different factors. Also, it remains unclear what the appropriate threshold for monitoring should be.