Piracetam for fetal distress in labour

Piracetam is thought to support the metabolism of brain cells when they have an insufficient oxygen supply (hypoxia). It may, therefore, prevent any adverse effects for an infant with persistent fetal distress during labour.

This review set out to assess the effects of piracetam for suspected fetal distress in labour on method of delivery and newborn ill effects (morbidity). Only one controlled trial was identified. The trial randomised 96 women to receive either piracetam or a placebo. Piracetam treatment was associated with a trend toward reduced need for a caesarean section as the method of delivery and an improved outcome for the newborn as determined by respiratory problems and signs of hypoxia. The trial did not provide information about any side effects experienced by the mother. This evidence is insufficient for meaningful conclusions.

Authors' conclusions: 

There is not enough evidence to evaluate the use of piracetam for fetal distress in labour.

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Background: 

Piracetam is thought to promote the metabolism of brain cells when they are hypoxic. It has been used to prevent adverse effects of fetal distress.

Objectives: 

The objective of this review was to assess the effects of piracetam for suspected fetal distress in labour on method of delivery and perinatal morbidity.

Search strategy: 

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (15 February 2012).

Selection criteria: 

Randomised trials of piracetam compared with placebo or no treatment for suspected fetal distress in labour.

Data collection and analysis: 

Both review authors assessed eligibility and trial quality.

Main results: 

One study of 96 women was included. Piracetam compared with placebo was associated with a trend to reduced need for caesarean section (risk ratio 0.57, 95% confidence interval 0.32 to 1.03). There were no statistically significant differences between the piracetam and placebo group for neonatal morbidity (measured by neonatal respiratory distress) or Apgar score.

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