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Tocolytics for suspected intrapartum fetal distress
1Departement de Gynecologie et d'Obstetrique, Hopitaux Universitaires de Geneve, Boulevard de la Cluse 32, Geneve 14, Switzerland, 1211. rkulier@hotmail.com
The Cochrane Database of Systematic Reviews
|May 5, 2000
Summary
Prophylactic tocolysis may reduce fetal heart rate abnormalities in cases of suspected fetal distress. However, insufficient evidence exists to fully evaluate betamimetic use for clinically important outcomes.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Pharmacology
Background:
- Prophylactic tocolysis is widely used for suspected fetal distress, aiming to improve fetal oxygenation via uterine relaxation.
- Potential adverse maternal cardiovascular effects are a concern with tocolytic agents.
Purpose of the Study:
- To review the effects of tocolytic therapy for suspected fetal distress on fetal, maternal, and perinatal outcomes.
Main Methods:
- Searched Cochrane Pregnancy and Childbirth Group trials register and Cochrane Controlled Trials Register (up to February 1999).
- Included randomized trials comparing tocolytic therapy with no treatment or other tocolytic agents for suspected fetal distress.
- Assessed trial quality and extracted data.
Main Results:
- Tocolytic therapy reduced failed improvements in fetal heart rate abnormalities compared to no treatment (RR 0.26).
- Betamimetic therapy showed a non-significant trend towards reduced uterine activity compared to magnesium sulphate (RR 0.07).
Conclusions:
- Betamimetic therapy may decrease fetal heart rate abnormalities and uterine activity.
- More evidence is needed on clinically important outcomes to assess betamimetics for suspected fetal distress.