A Validation Study of Home Uterine Activity Monitoring Technology in Western Australia

EDITORIAL COMMENT: We accepted this paper for publication because it shows that there is technology available to reliably record uterine contractions and that the information can be transferred by a telecommunications system. As the authors indicate there is no consensus in the literature concerning the usefulness of home monitoring in the prevention of prematurity and whether the newer methods of biochemical monitoring will prove superior. Final judgement must be deferred until data are presented regarding testing this methodology on high and low-risk patients in their homes including those in areas remote from hospital.
Summary: Home uterine activity monitoring has been developed as an 'early warning' device to detect premature uterine activity, thereby encouraging earlier referral and tocolysis of women at risk of preterm delivery. This ambulatory monitoring system, utilizing a ring-guard tocodynamometer, was piloted in Western Australia to determine if it can reliably record and transmit antenatal uterine activity data in an Australian environment. Pregnant women were readily able to correctly apply and use the ambulatory monitoring device. The information collected was able to be transmitted using standard Australian telecommunications systems within our hospital environment. Validation studies with the ambulatory monitor and current external tocodynamometry hardware were performed. The ring-guard tocodynamometer detected more uterine activity at gestations less than 32 weeks compared with conventional external tocodynamometers. As term approached, however, the sensitivity of the ring-guard tocodynamometer decreased. A cross-sectional profile of antenatal uterine activity was developed for women at low risk of delivering preterm. A gradual increase in the number, duration and amplitude of uterine contractions as pregnancy advanced was observed.