OBJECTIVE: To assess the effect of home uterine contraction assessment
(HUCA) in twin pregnancies with preterm labor (PTL) at < 24 weeks' ge
station. STUDY DESIGN: In this retrospective, analytic study, patients
were stratified by whether HUCA had been prescribed before or after d
iagnosis of PTL. The main outcomes studied were time of PTL diagnosis
and delivery as well as birth weight and need for neonatal intensive c
are unit (NICU) admission. In 63 patients, 32 were prescribed HUCA aft
er PTL had been arrested at < 24 weeks (group I). Thirty-one women had
HUCA prescribed at 20 weeks' gestational age and then developed PTL a
t < 24 weeks (group II). RESULTS: Labor was diagnosed at similar times
in both groups (22.8 vs 23.4 weeks), but delivery was earlier in grou
p I (27.6 weeks vs. 34.7 weeks) than in group II. The birth weight in
group I was less (918 +/- 255 g), and of the 64 infants, 55 required N
ICU admission as compared to 2,340 +/- 525 g and 11 of 62 infants (P <
.0001, .0001) in group II, respectively. CONCLUSION: Women with twin
gestations and the diagnosis of PTL prior to 24 weeks deliver later in
gestation, and their infants weigh more and have fewer NICU admission
s if intensive prenatal surveillance is prescribed prior to the onset
of labor.