There's no place like home

Whether women should be admitted to hospital as the result of an episode of acute premature labour or sent home with medication and instruction to limit physical activity has been the cause of much debate, particularly in this era of rationed health care services. In current practice, women admitted for control of preterm labour tend to stay in hospital. C�line Goulet and colleagues conducted a randomized clinical trial that found no significant differences between women who returned home and those who stayed in the hospital until delivery.

Based on samples of 125 women in each group, the authors report that there were no differences in mean gestational age at delivery (37.52 weeks v. 37.50 weeks), in mean birth weight (2974 g vs. 3020 g), or in the proportion of preterm births or mean duration of neonatal stay in hospital, intensive care unit or immediate care nursery. The only difference uncovered by the authors was that the women who went home and returned to the hospital to deliver, subsequently went home sooner.

The authors say their findings mean that home care should be considered a viable alternative to hospital care for women experiencing preterm labour, but caution this move raises other concerns. "The effects of transferring the burden [of care] from professionals in hospitals to family members in the home needs to be examined further," the conclude the authors.

A randomized clinical trial of care for women with preterm labour: home management versus hospital management � C. Goulet et al