A controlled clinical trial of home care management versus hospital care management for preterm labour

Goulet, Céline; Gévry, Hélène; Gauthier, Robert; Lepage, Linda; Fraser, William D.; Aita, Marilyn

doi:10.1016/s0020-7489(00)00077-8

Cited by 20 publications

(12 citation statements)

References 23 publications

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“…Discharging women with preterm contractions without objective evidence of labor does not result in an increased risk of preterm births (190). A randomized study of women after they had received treatment comparing home care or hospital care did not show significant difference between the two groups in mean gestational age at delivery or mean birthweight (189).…”

Section: Stress Home Uterine Activity Monitoring and Bedrest In Hospmentioning

confidence: 91%

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Preterm delivery: an overview

Haram¹,

Mortensen²,

Wollen³

2003

Acta Obstet Gynecol Scand

121

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Preterm delivery is the leading factor causing neonatal mortality and morbidity. We have conducted a PubMed literature search to obtain an update on the etiology, diagnostic problems and therapeutic considerations of preterm delivery. Approximately 5-10% of all births are premature. Preterm labor is associated with preterm rupture of membranes, cervical incompetence, polyhydramnion, fetal and uterine anomalies, infections, social factors, stress, smoking, heavy work and other risk factors. The diagnosis is made on the patients presenting symptoms, clinical findings and of progressive effacement and dilatation of the cervix. Biochemical markers of preterm delivery are of minor importance in daily clinical work. Measurement of the cervix, however, is a practical and valuable tool to predict preterm delivery. Cervical cerclage can be useful in selected cases. Antibiotics may help to prevent preterm labor in cases of known etiologic agents (e.g. preterm rupture of membranes and urinary infection). The use of tocolytic agents such as beta-sympathetic receptor stimulators can be advocated for a few days. There is evidence that their long-term use is not beneficial and could even be harmful to the fetus. Calcium channel blockers (nifedipine) and a new selective oxytocin receptor antagonist, atosiban, appear to be as effective as beta-sympathomimetic drugs on uterine contractions with fewer side-effects. Prostaglandin synthetase inhibitors such as indomethacin may prevent uterine contractions and can be used prior to the 32nd week of pregnancy. A single course of corticosteroid treatment in two doses of 12 mg betamethasone or 6 mg of dexamethasone is important for the prevention of respiratory distress between the 24th and 34th weeks of pregnancy. Multiple doses may be harmful and should be avoided. In these cases management should depend on gestation age (fetal maturity). Uterine contractions after 34 weeks' gestation are not an indication for tocolytic treatment.

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Section: Stress Home Uterine Activity Monitoring and Bedrest In Hospmentioning

confidence: 91%

“…Home management is an attractive alternative to hospital care for women experiencing preterm labor (2,188,189). Discharging women with preterm contractions without objective evidence of labor does not result in an increased risk of preterm births (190).…”

Section: Stress Home Uterine Activity Monitoring and Bedrest In Hospmentioning

confidence: 99%

Preterm delivery: an overview

Haram¹,

Mortensen²,

Wollen³

2003

Acta Obstet Gynecol Scand

121

View full text Add to dashboard Cite

show abstract

“…Two randomized studies in Canada examined the difference between home care and hospitalization for the management of preterm labor. Goulet et al found that, although gestational age and birth weight were similar for the groups, the women in the home management group (n = 250) had less stress and were more satisfied with the support they received from their partners (Goulet et al, 2001). Harrison and colleagues evaluated a program of home care for women with preterm premature rupture of membranes, preterm labor, and multiple gestations, comparing the women to a historical control group of women cared for in the hospital (n = 427).…”

Section: Interventions To Prevent Preterm Labormentioning

confidence: 98%

Nursing's Contribution to the Literature on Preterm Labor and Birth

Freda

2003

Journal of Obstetric, Gynecologic & Neonatal Nursing

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Section: Stress Home Uterine Activity Monitoring and Bedrest In Hospmentioning

confidence: 99%

Preterm delivery: an overview

Haram¹,

Mortensen²,

Wollen³

2003

Acta Obstet Gynecol Scand

View full text Add to dashboard Cite

Preterm delivery is the leading factor causing neonatal mortality and morbidity. We have conducted a PubMed literature search to obtain an update on the etiology, diagnostic problems and therapeutic considerations of preterm delivery. Approximately 5-10% of all births are premature. Preterm labor is associated with preterm rupture of membranes, cervical incompetence, polyhydramnion, fetal and uterine anomalies, infections, social factors, stress, smoking, heavy work and other risk factors. The diagnosis is made on the patients presenting symptoms, clinical findings and of progressive effacement and dilatation of the cervix. Biochemical markers of preterm delivery are of minor importance in daily clinical work. Measurement of the cervix, however, is a practical and valuable tool to predict preterm delivery. Cervical cerclage can be useful in selected cases. Antibiotics may help to prevent preterm labor in cases of known etiologic agents (e.g. preterm rupture of membranes and urinary infection). The use of tocolytic agents such as b-sympathetic receptor stimulators can be advocated for a few days. There is evidence that their longterm use is not beneficial and could even be harmful to the fetus. Calcium channel blockers (nifedipine) and a new selective oxytocin receptor antagonist, atosiban, appear to be as effective as b-sympathomimetic drugs on uterine contractions with fewer side-effects. Prostaglandin synthetase inhibitors such as indomethacin may prevent uterine contractions and can be used prior to the 32nd week of pregnancy. A single course of corticosteroid treatment in two doses of 12 mg betamethasone or 6 mg of dexamethasone is important for the prevention of respiratory distress between the 24th and 34th weeks of pregnancy. Multiple doses may be harmful and should be avoided. In these cases management should depend on gestation age (fetal maturity). Uterine contractions after 34 weeks' gestation are not an indication for tocolytic treatment.

show abstract

A controlled clinical trial of home care management versus hospital care management for preterm labour

Cited by 20 publications

References 23 publications

Preterm delivery: an overview

Preterm delivery: an overview

Nursing's Contribution to the Literature on Preterm Labor and Birth

Preterm delivery: an overview

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