most of these risk markers are poor predictors of preterm
labor as they have variable sensitivities (35-60%) and positive
predictive values (15-30%) 11.
Home uterine activity monitoring (HUAM)
HUAM is based on the principle of tocodynamometry and
created a lot of interest and excitement among obstetricians
when it was first introduced. It was tried in women with risk
markers for preterm labor. The technic involves telemetric
recording of uterine contractions and transmission of the
same to a monitoring center and daily feed back from the
healthcare practitioner to offer patient support and advice.
Earlier studies showed that HUAM was effective in predicting
the onset of preterm labor, but they were criticized for their
flawed study design. To date about 13 randomized trials have
been done of HUAM and the results are inconclusive.
Recently, a large randomized trial involving 2422 patients
showed no benefit of HUAM in predicting preterm labor 12.
Hence, it cannot be recommended in routine clinical practice.