G J Hofmeyr1, R Kulier. 1. Department of Obstetrics and Gynaecology, Coronation Hospital and University of the Witwatersrand, 7 York Road, Parktown 2193, Johannesburg, South Africa. 091just@chiron.wits.ac.za
Abstract
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.
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.
Authors: Leonel Briozzo; Alma Martinez; Maria Nozar; Veronica Fiol; Jose Pons; Justo Alonso Journal: J Obstet Gynaecol Res Date: 2007-06 Impact factor: 1.730