Fetal manipulation for facilitating tests of fetal wellbeing

BACKGROUND: Manual fetal manipulation 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 manual fetal manipulation in conjunction with tests of fetal wellbeing. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (October 2007). SELECTION CRITERIA: All published and unpublished randomised controlled trials assessing the merits of the use of fetal manipulation in conjunction with tests of fetal wellbeing. DATA COLLECTION AND ANALYSIS: Both review authors independently extracted data and assessed trial quality. Authors of published and unpublished trials were contacted for further information. MAIN RESULTS: Only three trials with a total of 1100 women with 2130 episodes of participation were included. Manual fetal manipulation did not decrease the incidence of non-reactive antenatal cardiotocography test (odds ratio 1.28, 95% confidence interval 0.94 to 1.74). AUTHORS' CONCLUSIONS: Manual fetal manipulation has not been shown to reduce the incidence of non-reactive cardiotocography. Trials of manual fetal manipulation should take into consideration that there have not been any benefits demonstrated as yet.