Background: Suspected fetal distress usually results in expedited delivery of a baby (often operatively). The potential harm to a mother and baby from operative delivery may not always be justified especially when fetal distress may be misdiagnosed. Even with a correct diagnosis it is not clear whether an operative or conservative approach is better.
Objectives: The objective of this review was to assess the effects of operative management for fetal distress on maternal and perinatal morbidity.
Search methods: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (15 February 2012).
Selection criteria: Randomised trials of operative (caesarean section or expedited vaginal delivery) versus conservative management of suspected fetal distress.
Data collection and analysis: Trial quality assessment and data extraction were done by both review authors.
Main results: One study of 350 women was included. This trial was carried out in 1959. There was no difference in perinatal mortality (risk ratio 1.18, 95% confidence interval 0.56 to 2.48).
Authors' conclusions: There have been no contemporary trials of operative versus conservative management of suspected fetal distress. In settings without modern obstetric facilities, a policy of operative delivery in the event of meconium-stained liquor or fetal heart rate changes has not been shown to reduce perinatal mortality.