Tocolysis for assisting delivery at caesarean section

BACKGROUND: Caesarean 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. OBJECTIVES: To 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 STRATEGY: We 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 CRITERIA: Use 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 ANALYSIS: Two review authors independently assessed trial quality and extracted data. MAIN RESULTS: A single randomised trial involving 97 women was identified and included in the review. Maternal and infant health outcomes were not reported. AUTHORS' CONCLUSIONS: There 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.Jodie M Dodd, Kym Rei