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Tocolysis for assisting delivery at caesarean sectionDodd JM, Reid K
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SummaryTocolysis to relax the uterus and assist birth at difficult caesarean sectionsCaesarean section involves making an incision in the woman's abdomen and cutting through the wall of the uterus. The baby is then born through these incisions. Medication to relax the uterus (tocolytic drugs) has been suggested to facilitate the birth of the baby at difficult caesarean section and reduce the risk of birth trauma, like fractures and nerve damage. There are risks associated with the use of medication to relax the uterus, including excessive bleeding and possible interference with the blood the baby receives from the placenta at birth. There is currently limited evidence available to help with informed decisions around the use of these drugs at difficult caesareans. Until there is evidence that these drugs do more good than harm, they should not be used.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2010 Issue 1, Copyright © 2010 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
This version first published online:
October 18. 2006 AbstractBackgroundCaesarean section involves making an incision in the woman's abdomen and cutting through the uterine muscle. The baby is then delivered through that incision. Difficult caesarean birth may result in injury for the infant. Medication that relaxes the uterus (tocolytic medication) may facilitate the birth of the baby at caesarean section. ObjectivesTo compare the use of tocolysis (routine or selective use) with no use of tocolysis or placebo at the time of caesarean section for outcomes of infant birth trauma, maternal complications (particularly postpartum haemorrhage requiring blood transfusion), and long-term measures of infant and childhood morbidity. Search strategyWe searched the Cochrane Pregnancy and Childbirth Group's Trials Register (January 2006), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2006, Issue 1) and PubMed (1966 to January 2006). Selection criteriaUse of tocolytic agents (routine or selective) at caesarean section versus no use of tocolytic or placebo at caesarean section to facilitate the birth of the baby. Data collection and analysisTwo review authors independently assessed trial quality and extracted data. Main resultsA single randomised trial involving 97 women was identified and included in the review. Maternal and infant health outcomes were not reported. Authors' conclusionsThere is currently insufficient information available from randomised trials to support or refute the routine or selective use of tocolytic agents to facilitate infant birth at the time of caesarean section. |