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July 21, 1993

Home Uterine Activity Monitoring for Preterm LaborPolicy Statement

JAMA. 1993;270(3):369-370. doi:10.1001/jama.1993.03510030093041

SUMMARY OF RECOMMENDATION  There is insufficient evidence of clinical effectiveness to recommend for or against home uterine activity monitoring (HUAM) as a screening test for preterm labor in high-risk pregnancies (pregnancies with risk factors for preterm labor). According to the US Preventive Services Task Force (USPSTF) coding system (Tables 1 and 2), this represents a "C" recommendation. Randomized, controlled trials (grade I evidence) report improved clinical neonatal outcomes for high-risk women who receive HUAM. However, the designs of most studies do not permit clear conclusions about whether the results were due to HUAM or to the intensive nursing contacts that accompanied HUAM.There have been no controlled trials of HUAM in normal pregnancies (pregnancies with no risk factors for preterm labor). In view of the cost of HUAM and the poor evidence that it is efficacious in high-risk pregnancies, the USPSTF recommends against the use of HUAM in normal pregnancy.