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 methods We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (October 2007). We updated this search on 6 July 2012 and added the results to the awaiting classification section of the review. Selection criteria All published and unpublished randomised controlled trials assessing the merits of the use of fetal manipulation in conjunction with tests of fetal wellbeing.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 Authors of published and unpublished trials were contacted for further information.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. [Note: the two citations in the awaiting classification section may alter the conclusions of the review once assessed.]