Elective versus selective caesarean section for delivery of the small baby

Abstract

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.

Objectives: The objective of this review was to assess the effects of a policy of elective caesarean delivery versus selective caesarean delivery for women in preterm labour.

Search strategy: The Cochrane Pregnancy and Childbirth Group trials register was searched.

Selection criteria: Randomised trials comparing a policy of elective caesarean delivery with expectant management with recourse to caesarean section.

Data collection and analysis: One reviewer assessed eligibility and trial quality.

Main results: Five studies involving 104 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.

Reviewer's 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 presenting cephalically.