Prophylactic manual rotation for fetal malposition to reduce operative delivery

摘要: Background Manual rotation is commonly performed to increase the chances of normal vaginal delivery and perceived be safe. Manual has potential prevent operative caesarean section, reduce obstetric neonatal complications. Objectives To assess effect prophylactic manual for women with malposition in labour on mode delivery, maternal outcomes. Search methods We searched Cochrane Pregnancy Childbirth Group’s Trials Register (31 October 2014), Australian New Zealand Clinical Registry (ANZCTR), ClinicalTrials.gov, Current Controlled WHO International Platform (ICTRP) (all 23 February previous reviews and, references retrieved studies. Selection criteria Randomised, quasi-randomised or cluster-randomised clinical trials comparing fetal versus expectant management, augmentation delivery. We defined as without immediate assisted delivery. Data collection analysis Two review authors independently assessed study eligibility quality, extracted data. Main results We included only one small pilot (involving 30 women). The study, which we considered at low risk bias, was conducted a tertiary referral hospital Australia, involved cephalic, singleton pregnancies. primary outcome (instrumental section). In group, 13/15 went have an instrumental whereas control 12/15 had estimated ratio 1.08 (95% confidence interval 0.79 1.49). There were no mortalities either group There clear differences any secondary outcomes reported (e.g. perineal trauma, analgesia use duration labour). In terms adverse events, there cases umbilical cord prolapse cervical laceration single case non-reassuring pathological cardiotocograph during procedure. Authors' conclusions Currently, insufficient evidence determine efficacy early second stage prevention One additional ongoing. Further appropriately designed are required rotation.