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Abdominal decompression for suspected fetal compromise/pre-eclampsia

  • Review
  • Intervention


  • G Justus Hofmeyr

    Corresponding author
    1. University of the Witwatersrand, University of Fort Hare, Eastern Cape Department of Health, Department of Obstetrics and Gynaecology, East London Hospital Complex, East London, Eastern Cape, South Africa
    • G Justus Hofmeyr, Department of Obstetrics and Gynaecology, East London Hospital Complex, University of the Witwatersrand, University of Fort Hare, Eastern Cape Department of Health, Frere and Cecilia Makiwane Hospitals, Private Bag X 9047, East London, Eastern Cape, 5200, South Africa.

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Abdominal decompression was developed as a means of pain relief during labour. It has also been used for complications of pregnancy, and in healthy pregnant women in an attempt to improve fetal wellbeing and intellectual development.


The objective of this review was to assess the effects of antenatal abdominal decompression for maternal hypertension or impaired fetal growth, on perinatal outcome.

Search methods

The Cochrane Pregnancy and Childbirth Group's Trials Register (October 2008).

Selection criteria

Randomised or quasi-randomised trials comparing abdominal decompression with no decompression in women with pre-eclampsia and/or fetuses thought to be compromised.

Data collection and analysis

Eligibility and trial quality were assessed by one review author.

Main results

Three studies were included, all with the possibility of containing serious bias. Therapeutic abdominal decompression was associated with the following reductions: persistent pre-eclampsia (relative risk 0.36, 95% confidence interval 0.18 to 0.72); fetal distress in labour (relative risk 0.37, 95% confidence interval 0.19 to 0.71); low birthweight (relative risk 0.50, 95% confidence interval 0.40 to 0.63); Apgar scores less than six at one minute (relative risk 0.26, 95% confidence interval 0.12 to 0.56); and perinatal mortality (relative risk 0.39, 95% confidence interval 0.22 to 0.71).

Authors' conclusions

Due to the methodological limitations of the studies, the effects of therapeutic abdominal decompression are not clear. The apparent improvements in birthweight and perinatal mortality warrant further evaluation of abdominal decompression where there is impaired fetal growth and possibly for women with pre-eclampsia.








我們搜尋出現在The Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register的相關文獻;最後一次搜尋的日期是2004年10月25日。






總共找到3個試驗,但是都有嚴重的偏差。治療性的腹部減壓可以減少下列情況的發生:持續性的子癲前症(相對危險性RR 0.36,95% C .18 – 0.72);待產時出現胎兒窘迫(RR 0.37,95% CI 0.19 – 0.71);低出生體重(RR 0.50,95% CI 0.40 – 0.63);出生後1分鐘Apgar評分小於6(R .26,95% CI 0.12 – 0.56);以及周產期死亡率(RR 0.39,95% C .22 – 0.71)。




本摘要由周產期醫學會(Taiwan Society of Perinatology)洪泰和翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。



Plain language summary

Antenatal abdominal decompression for maternal hypertension or impaired fetal growth

Abdominal decompression was first used to increase blood flow and the forward movement of the uterus during labour contractions as a way of relieving pain. A rigid covered dome is placed about the abdomen and the space around the abdomen is decompressed to -50 to -100 mm Hg for 15 to 30 seconds out of each minute for 30 minutes once to thrice daily, or continuously during labour. Observations that fetal wellbeing appeared to be improved led to its investigation for complications of pregnancy.

Three randomised controlled studies with a total of 356 pregnant women were identified from a search of the medical literature, all with the possibility of containing serious methodological limitations. The studies were reported on between 1967 and 1973. One study involved women with pre-eclampsia, essential hypertension, or chronic nephritis. The other two trials assigned women carrying babies that were small for their gestational age to abdominal decompression or no decompression.

Abdominal decompression appeared to have a beneficial effect on the progression of pre-eclampsia. This one trial also reported less fetal distress during labour and fewer low 1-minute Apgar scores in the group who received abdominal decompression. The apparent large improvement in birthweight and perinatal deaths reported in all three studies is sufficiently striking to warrant the further evaluation of abdominal decompression in cases of impaired fetal growth, and possibly for women with pre-eclampsia, by means of methodologically sound controlled trials. Because of the methodological shortcomings mentioned above, clinical use of abdominal decompression cannot be supported on the basis of the present trials.

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