Related Experiment Videos
Operative versus conservative management for 'fetal distress' in labour
1Department of Obstetrics and Gynaecology, Coronation Hospital and University of the Witwatersrand, 7 York Road, Parktown 2193, Johannesburg, South Africa. 091just@chiron.wits.ac.za
Background:
Suspected fetal distress usually results in expedited delivery of a baby (often operatively). The potential harm to a mother and baby from operative delivery may not always be justified especially when fetal distress may be misdiagnosed. Even with a correct diagnosis it is not clear whether an operative or conservative approach is better.
Objectives:
The objective of this review was to assess the effects of operative management for fetal distress on maternal and perinatal morbidity.
Search Strategy:
The Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register were searched. Date of last search: October 1997.
Selection Criteria:
Randomised trials of operative (caesarean section or expedited vaginal delivery) versus conservative management of suspected fetal distress.
Data Collection And Analysis:
Trial quality assessment and data extraction were done by both reviewers.
Main Results:
One study of 350 women was included. This trial was carried out in 1959. There was no difference in perinatal mortality (relative risk 1.18, 95% confidence interval 0.56 to 2.48).
Reviewer'S Conclusions:
There have been no contemporary trials of operative versus conservative management of suspected fetal distress. In settings without modern obstetric facilities, a policy of operative delivery in the event of meconium-stained liquor or fetal heart rate changes has not been shown to reduce perinatal mortality.