Fetal manipulation for facilitating tests of fetal wellbeing

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Abstract
Manual fetal manipulation has been suggested to improve the efficiency of antepartum fetal heart rate testing. 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. We searched the Cochrane Pregnancy and Childbirth Group trials register in June 2001. All published and unpublished randomized controlled trials assessing the merits of the use of fetal manipulation in conjunction with tests of fetal wellbeing. Both reviewers independently extracted data and assessed trial quality. Authors of published and unpublished trials were contacted for further information. Only two trials with a total of 1090 women with 2110 episodes of participation were included. Manual fetal manipulation did not decrease the incidence of non-reactive antenatal cardiotocography test (odds ratio 1.28 confidence interval 0.94-1.74). 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.

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