Cardiotocography for antepartum fetal assessment.

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.