THE ROLE OF OBSTETRICAL MEDICAL TECHNOLOGY IN PREVENTING LOW-BIRTH-WEIGHT

Technology plays an important role in the practice of medicine, and it is essential that controlled clinical trials be conducted before new technologies are widely disseminated. In this article, information fro m the medical literature is summarized and critiqued for several commo n obstetric technologies which are aimed at reducing the incidence or sequelae of low birth weight and preterm birth. These technologies inc lude home uterine activity monitoring, tocolytic drugs to suppress ute rine contractions, corticosteroids to accelerate fetal lung maturity, bed rest to prevent preterm delivery, delivery methods, multifetal pre gnancy reduction, and cervical cerclage. A major challenge to the prac tice of medicine is to find effective ways to modify physician behavio r to encourage the use of proven, effective technologies, and discoura ge the use of unproven, ineffective technologies. Despite widespread u se, most obstetrical technologies appear to have had little impact on reducing the incidence of low birth weight or preterm births, as rates of low birth weight and preterm birth have not decreased appreciably in the past 25 years. Uncovering the basic mechanisms responsible for the onset of preterm labor will undoubtedly facilitate the discovery o f new technologies to prevent low birth weight and preterm births.