Elective versus selective caesarean section for delivery of the small baby.
BACKGROUND
Elective caesarean delivery for women in preterm labour might reduce the chances of fetal or neonatal death, but it might also increase the risk of maternal morbidity.


OBJECTIVE
To assess the effects of a policy of elective caesarean delivery versus selective caesarean delivery for women in preterm labour.


METHODS
The Cochrane Pregnancy and Childbirth Group trials register was searched. Date of last search: September 2000.


METHODS
Randomised trials comparing a policy of elective caesarean delivery versus expectant management with recourse to caesarean section.


METHODS
One reviewer assessed eligibility and trial quality, and both contributed to the update.


RESULTS
Six studies involving 122 women were included. All trials reported recruiting difficulties. No significant differences between elective and selective policies for caesarean delivery were found for fetal, neonatal or maternal outcomes.


CONCLUSIONS
There is not enough evidence to evaluate the use of a policy for elective caesarean delivery for small babies. Randomised trials in this area are likely to continue to experience recruitment problems. However, it still may be possible to investigate elective caesarean delivery in preterm babies with cephalic presentations.
Health Services Research Unit, The Polwarth Building, Foresterhill, Aberdeen, UK, AB9 2ZD. a.grant@abdn.ac.uk
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Grant
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Glazener
D002585:Cesarean Section; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007752:Obstetric Labor, Premature; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic