Assessment of uterine activity in ambulatory patients at high risk of preterm labor and delivery

A Comparison of Gestational Days Gained with Oral Terbutaline Versus Continuous Subcutaneous Terbutaline in Women with Twin Gestations

“…Furthermore, we observed that uterine activity increases before the onset of preterm labor in women with twin gestations. This is supportive of the works of Nageotte et al, 20 Katz et al, 21 and Garite et al, 22 who showed a surge, or crescendo, of uterine activity 3 days before the onset of spontaneous labor.…”

Uterine Contraction Monitoring, Maintenance Tocolysis, and Preterm Birth

“…These patients have all been shown to benefit from uterine activity monitoring (tertiary prevention). (Morrison et al, 2001;Katz et al, 1986;Watson et al, 1990;Kosasa et al, 1990) Contraction assessment is particularly important in MFG as the contraction pattern is different from that in singletons. Newman et al, (1986) demonstrated that twins have statistically more contractions/hr than singletons averaging 2/hr at 29 weeks, 3/h at 33 weeks, and 4/h at 36 weeks.…”

“…(Morrison et al, 2001;Katz et al, 1986;Watson et al, 1990;Kosasa et al, 1990;Smith et al, 1994) Furthermore, after tocolysis of the second PTL episode or in pregnancies with advanced cervical dilation (>3-4cm), the combination of continued uterine contraction monitoring along with subcutaneous terbutaline infusion using a programmable pump have resulted in significantly prolonged gestation compared to no treatment or oral maintenance therapy. (Elliott et al, 2001;Morrison et al, 2003;Lam et al, 2001) Both contraction monitoring and terbutaline administration by subcutaneous pump, when used in appropriate patients, significantly increased the length of pregnancy, resulted in fewer low birth weight infants, and reduced neonatal stay as well as neonatal cost.…”

Prevenção do Nascimento Prematuro: Importância da Monitorização das Contrações Uterinas

“…De forma inversa, as que não apresentam parto prematuro possuem freqüência máxima menor ou igual a 3 contrações/h antes da 28 a semana de gestação e menor ou igual a 5 contrações/h entre a 29 a e 32 a18 . Os estudos comparativos entre a monitorização externa das contrações uterinas com o tocodinamômetro e a autopalpação demonstram melhores resultados quando utilizado o primeiro método 16,18 . Em tais estudos o diagnóstico do TPP se deu em 92% dos casos monitorizados com dilatação cervical inferior a 2 cm, o que permitiu um ganho de tempo intra-útero significativamente maior nesta população.…”

“…Contudo, a maioria dos estudos tem considerado a freqüência normal máxima menor ou igual a 3 contrações/h 16,18,19,20,21 . Main et al 16 consideram a freqüência superior ou igual a 4 contrações/h, com 35 segundos ou mais e amplitude maior ou igual a 5 mm, preditivas do parto pré-termo.…”