Fetal vibroacoustic stimulation for facilitation of tests of fetal wellbeing.

BACKGROUND

Acoustic stimulation of the fetus has been suggested to improve the efficiency of antepartum fetal heart rate testing.

OBJECTIVES

The objective of this review was to assess the merits or adverse effects of the use of fetal vibroacoustic stimulation in conjunction with tests of fetal wellbeing.

SEARCH STRATEGY

We searched the Cochrane Pregnancy and Childbirth Group trials register. Date of last search: October 2000.

SELECTION CRITERIA

All published and unpublished randomized controlled trials assessing the merits of the use of fetal vibroacoustic stimulation in conjunction with tests of fetal wellbeing.

DATA COLLECTION AND ANALYSIS

Both reviewers independently extracted data and assessed trial quality. Authors of published and unpublished trials were contacted for further information.

MAIN RESULTS

A total of seven trials with a total of 4325 participants were included. Fetal vibroacoustic stimulation reduced the incidence of non-reactive antenatal cardiotocography test (odds ratio (OR) 0.61, 95% confidence interval (CI) 0.49-0.75) and reduced the overall mean cardiotocography testing time (weighted mean difference (WMD) -4.55 minutes, 95% CI -5.96 minutes to -3.14 minutes). Vibroacoustic stimulation evoked more than mock stimulation when used in conjunction with fetal heart rate testing (OR 0.08, 95% CI 0.06-0.12).

REVIEWER'S CONCLUSIONS: Vibroacoustic stimulation offers benefits by decreasing the incidence of non-reactive cardiotocography and reducing the testing time. Further randomized trials should be encouraged to determine not only the optimum intensity, frequency, duration and position of the vibroacoustic stimulation, but also to evaluate the efficacy, predictive reliability, safety and perinatal outcome of these stimuli with cardiotocography and other tests of fetal wellbeing.