Hofmeyr G Justus, Kulier Regina
Department of Obstetrics and Gynaecology, East London Hospital Complex, University of the Witwatersrand, University of FortHare, Eastern Cape Department of Health, East London, South Africa.
Cochrane Database Syst Rev. 2012 Jun 13;2012(6):CD001065. doi: 10.1002/14651858.CD001065.pub2.
Suspected fetal distress usually results in expedited delivery of a baby (often operatively). The potential harm to a mother and baby from operative delivery may not always be justified especially when fetal distress may be misdiagnosed. Even with a correct diagnosis it is not clear whether an operative or conservative approach is better.
The objective of this review was to assess the effects of operative management for fetal distress on maternal and perinatal morbidity.
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (15 February 2012).
Randomised trials of operative (caesarean section or expedited vaginal delivery) versus conservative management of suspected fetal distress.
Trial quality assessment and data extraction were done by both review authors.
One study of 350 women was included. This trial was carried out in 1959. There was no difference in perinatal mortality (risk ratio 1.18, 95% confidence interval 0.56 to 2.48).
AUTHORS' CONCLUSIONS: There have been no contemporary trials of operative versus conservative management of suspected fetal distress. In settings without modern obstetric facilities, a policy of operative delivery in the event of meconium-stained liquor or fetal heart rate changes has not been shown to reduce perinatal mortality.
疑似胎儿窘迫通常会导致加快分娩（通常通过手术方式）。手术分娩对母婴的潜在危害可能并不总是合理的，尤其是当胎儿窘迫可能被误诊时。即使诊断正确，也不清楚手术治疗还是保守治疗更好。
本综述的目的是评估胎儿窘迫手术治疗对孕产妇和围产期发病率的影响。
我们检索了Cochrane妊娠和分娩组试验注册库（2012年2月15日）。
对疑似胎儿窘迫进行手术治疗（剖宫产或加速阴道分娩）与保守治疗的随机试验。
两位综述作者进行试验质量评估和数据提取。
纳入了一项针对350名女性的研究。该试验于1959年进行。围产期死亡率无差异（风险比1.18，95%置信区间0.56至2.48）。
目前尚无关于疑似胎儿窘迫手术治疗与保守治疗的当代试验。在没有现代产科设施的情况下，对于羊水胎粪污染或胎儿心率变化采取手术分娩的政策并未显示能降低围产期死亡率。
