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Choosing Wisely: Bedrest-A Panacea for All That Ails the Gravida?
1Department of Obstetrics and Gynaecology, Royal Alexandra Hospital, University of Alberta, Edmonton, AB.
Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'Obstetrique Et Gynecologie Du Canada : JOGC
|May 5, 2019
Summary
Bedrest is often prescribed for high-risk pregnancies, but current evidence shows no benefit for conditions like preterm birth or preeclampsia. In fact, reduced activity may cause harm, while exercise is known to be beneficial.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
Background:
- Bedrest is a common intervention for various high-risk pregnancy conditions.
- Indications include concerns about preterm birth, antepartum hemorrhage, and conditions like preeclampsia or fetal growth restriction.
Purpose of the Study:
- To evaluate the evidence supporting the use of bedrest or reduced activity in high-risk pregnancies.
- To determine the benefits and harms associated with prescribing bedrest during pregnancy.
Main Methods:
- Review of existing literature and clinical guidelines regarding bedrest in pregnancy.
- Analysis of studies examining the efficacy of bedrest for conditions such as preterm birth, antepartum hemorrhage, preeclampsia, and fetal growth restriction.
Main Results:
- No evidence supports the benefit of bedrest for reducing preterm birth or improving outcomes in preeclampsia or fetal growth restriction.
- Concerns regarding antepartum hemorrhage and placenta previa are not definitively alleviated by bedrest.
- Evidence suggests potential harm from bedrest and highlights the known benefits of exercise during pregnancy.
Conclusions:
- Bedrest is not recommended for the management of high-risk pregnancies due to a lack of proven benefit and potential for harm.
- Healthcare providers should reconsider the routine prescription of bedrest and encourage safe physical activity during pregnancy.
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