Tocolysis for preventing fetal distress in second stage of labour.

BACKGROUND

Prophylactic tocolysis with betamimetics and other agents has become widespread as a treatment for fetal distress. Uterine relaxation may improve placental blood flow and therefore fetal oxygenation. However there may also be adverse maternal cardiovascular effects.

OBJECTIVES

The objective of this review was to assess the effects of prophylactic betamimetic therapy during the second stage of labour on perinatal outcome.

SEARCH STRATEGY: The Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register were searched. Date of last search: February 1999.

SELECTION CRITERIA: Randomised trials comparing prophylactic intravenous betamimetic therapy during the second stage of labour with placebo or no treatment in uncomplicated pregnancies.

DATA COLLECTION AND ANALYSIS: The reviewers assessed trial quality and extracted data.

MAIN

RESULTS

One study involving 100 women was included. Compared to placebo, prophylactic betamimetic therapy was associated with an increase in forceps deliveries (relative risk 1.83, 95% confidence interval 1.02 to 3. 29). There were no clear effects on postpartum haemorrhage, neonatal irritability, feeding slowness, umbilical arterial pH values or Apgar scores at 2 minutes.

REVIEWER'S

CONCLUSIONS

There is no evidence to support the prophylactic use of betamimetics during the second stage of labour.