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INTRAUTERINE GROWTH RESTRICTION |
Cochrane Database Syst Rev. 2000;(2):CD001068.
Cardiotocography for antepartum fetal assessment.
Pattison N, McCowan L.
Department of Obstetrics and Gynaecology, School of Medicine, University of
Auckland, Auckland, New Zealand. n. Pattison@auckland. Ac.nz
Background:
Cardiotocography is a form of fetal assessment which
simultaneously records fetal heart rate, fetal movements and uterine
contractions to investigate hypoxia.
Objectives:
The objective was to assess
the effects of antenatal cardiotocography on perinatal morbidity and
mortality and maternal morbidity.
Search Strategy:
We searched the Cochrane
Pregnancy and Childbirth Group trials register and the Cochrane Controlled
Trials Register (to 1 November 1998).
Selection Criteria:
Randomised trials
comparing antenatal cardiotocography with a control group for fetal
assessment. DATA COLLECTION AND ANALYSIS: Trial quality was assessed.
Main Results:
Four studies involving 1,588 pregnancies were included. All trials
were conducted on high or intermediate risk pregnancies. Antenatal
cardiotocography appeared to have no significant effect on perinatal
mortality or morbidity. There was a trend to an increase in perinatal deaths
in the cardiotocography group (odds ratio 2.85, 95% confidence interval 0.99
to 7.12). There was no increase in the incidence of interventions such as
elective caesarean section or induction of labour. The one trial which
examined an effect on antenatal patient management showed a significant
reduction in hospital admissions and a reduction in inpatient stay in the
cardiotocography group. REVIEWER'S Conclusions:
There is not enough evidence
to evaluate the use of antenatal cardiotocography for fetal assessment. All
of the trials included in this review date from the introduction of
antenatal cardiotocography and may be difficult to relate to current
practice.
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