A M Gülmezoglu1, G J Hofmeyr. 1. Special Department of Research, Development and Research Training in Human Reproduction, UNDP/UNFPA/WHO/World Bank, World Health Organisation, Geneva 27, Switzerland, CH-1211. gulmezoglum@who.ch
Abstract
BACKGROUND: Bed rest in hospital or at home is widely advised for many complications of pregnancy. The increased clinical supervision needs to be balanced with the risk of thrombosis, the stress on the pregnant women, as well as the costs to families and health services. OBJECTIVES: The objective of this review was to assess the effects of bed rest in hospital for women with suspected impaired fetal growth. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register. Date of last search: December 1999. SELECTION CRITERIA: Randomised trials comparing a policy of bed rest in hospital with ambulatory management for women with suspected impaired fetal growth. DATA COLLECTION AND ANALYSIS: Trial quality was assessed. MAIN RESULTS: One study involving 107 women was included. Allocation of treatment was by odd or even birth date. There were differences in baseline fetal weights and birth weights, but these were not statistically significant (mean estimated fetal weight deviation at enrolment was -21.7% for the bed rest group and -20.7% for the ambulatory group; mean estimated birth weight was -19.7% for the bed rest group and -20.6% for the ambulatory group). No differences were detected between bed rest and ambulatory management for fetal growth parameters (relative risk 0.43, 95% confidence interval: 0.15 to 1. 27) and neonatal outcomes. REVIEWER'S CONCLUSIONS: There is not enough evidence to evaluate the use of a bed rest in hospital policy for women with suspected impaired fetal growth.
BACKGROUND: Bed rest in hospital or at home is widely advised for many complications of pregnancy. The increased clinical supervision needs to be balanced with the risk of thrombosis, the stress on the pregnant women, as well as the costs to families and health services. OBJECTIVES: The objective of this review was to assess the effects of bed rest in hospital for women with suspected impaired fetal growth. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register. Date of last search: December 1999. SELECTION CRITERIA: Randomised trials comparing a policy of bed rest in hospital with ambulatory management for women with suspected impaired fetal growth. DATA COLLECTION AND ANALYSIS: Trial quality was assessed. MAIN RESULTS: One study involving 107 women was included. Allocation of treatment was by odd or even birth date. There were differences in baseline fetal weights and birth weights, but these were not statistically significant (mean estimated fetal weight deviation at enrolment was -21.7% for the bed rest group and -20.7% for the ambulatory group; mean estimated birth weight was -19.7% for the bed rest group and -20.6% for the ambulatory group). No differences were detected between bed rest and ambulatory management for fetal growth parameters (relative risk 0.43, 95% confidence interval: 0.15 to 1. 27) and neonatal outcomes. REVIEWER'S CONCLUSIONS: There is not enough evidence to evaluate the use of a bed rest in hospital policy for women with suspected impaired fetal growth.
Authors: Nir Melamed; Ahmet Baschat; Yoav Yinon; Apostolos Athanasiadis; Federico Mecacci; Francesc Figueras; Vincenzo Berghella; Amala Nazareth; Muna Tahlak; H David McIntyre; Fabrício Da Silva Costa; Anne B Kihara; Eran Hadar; Fionnuala McAuliffe; Mark Hanson; Ronald C Ma; Rachel Gooden; Eyal Sheiner; Anil Kapur; Hema Divakar; Diogo Ayres-de-Campos; Liran Hiersch; Liona C Poon; John Kingdom; Roberto Romero; Moshe Hod Journal: Int J Gynaecol Obstet Date: 2021-03 Impact factor: 3.561