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. 2013 Dec 7;2013(12):CD002963.
doi: 10.1002/14651858.CD002963.pub2.

Fetal vibroacoustic stimulation for facilitation of tests of fetal wellbeing

Kelvin H Tan  1 , Rebecca M D Smyth, Xing Wei
Affiliations

Fetal vibroacoustic stimulation for facilitation of tests of fetal wellbeing

Kelvin H Tan et al. Cochrane Database Syst Rev. .

Abstract

Background: Acoustic stimulation of the fetus has been suggested to improve the efficiency of antepartum fetal heart rate testing.

Objectives: To assess the advantages and disadvantages of the use of fetal vibroacoustic stimulation in conjunction with tests of fetal wellbeing.

Search methods: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2013).

Selection criteria: All published and unpublished randomised controlled trials assessing the merits of the use of fetal vibroacoustic stimulation in conjunction with tests of fetal wellbeing.

Data collection and analysis: All review authors independently extracted data and assessed trial quality. Authors of published and unpublished trials were contacted for further information.

Main results: Altogether 12 trials with a total of 6822 participants were included. Fetal vibroacoustic stimulation reduced the incidence of non-reactive antenatal cardiotocography test (nine trials; average risk ratio (RR) 0.62, 95% confidence interval (CI) 0.48 to 0.81). Vibroacoustic stimulation compared with mock stimulation evoked significantly more fetal movements when used in conjunction with fetal heart rate testing (one trial, RR 0.23, 95% CI 0.18 to 0.29).

Authors' conclusions: Vibroacoustic stimulation offers benefits by decreasing the incidence of non-reactive cardiotocography and reducing the testing time. Further randomised trials should be encouraged to determine not only the optimum intensity, frequency, duration and position of the vibroacoustic stimulation, but also to evaluate the efficacy, predictive reliability, safety and perinatal outcome of these stimuli with cardiotocography and other tests of fetal wellbeing.

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Conflict of interest statement

None known.

Figures

1
1
'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
2
2
'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
1.1
1.1. Analysis
Comparison 1 Fetal vibroacoustic stimulation versus mock or no stimulation, Outcome 1 Non reactive cardiotocography test.
1.2
1.2. Analysis
Comparison 1 Fetal vibroacoustic stimulation versus mock or no stimulation, Outcome 2 Mean overall fetal heart rate testing time.
1.3
1.3. Analysis
Comparison 1 Fetal vibroacoustic stimulation versus mock or no stimulation, Outcome 3 Absence of fetal movements by palpation or visualisation.
1.4
1.4. Analysis
Comparison 1 Fetal vibroacoustic stimulation versus mock or no stimulation, Outcome 4 Fetal distress within 7 days.
1.5
1.5. Analysis
Comparison 1 Fetal vibroacoustic stimulation versus mock or no stimulation, Outcome 5 False positive in prediction of fetal distress within 7 days.
1.6
1.6. Analysis
Comparison 1 Fetal vibroacoustic stimulation versus mock or no stimulation, Outcome 6 False negative in prediction of fetal distress within 7 days.
1.7
1.7. Analysis
Comparison 1 Fetal vibroacoustic stimulation versus mock or no stimulation, Outcome 7 Perinatal deaths.
1.8
1.8. Analysis
Comparison 1 Fetal vibroacoustic stimulation versus mock or no stimulation, Outcome 8 Impairment of fetal hearing.
1.12
1.12. Analysis
Comparison 1 Fetal vibroacoustic stimulation versus mock or no stimulation, Outcome 12 Mean testing time for modified biophysical profile ‐ not prespecified outcome.
1.13
1.13. Analysis
Comparison 1 Fetal vibroacoustic stimulation versus mock or no stimulation, Outcome 13 Non‐reassuring biophysical profile ‐ not prespecified outcome.
2.1
2.1. Analysis
Comparison 2 Fetal vibroacoustic stimulation versus mock stimulation, Outcome 1 Non reactive cardiotocography test.
2.2
2.2. Analysis
Comparison 2 Fetal vibroacoustic stimulation versus mock stimulation, Outcome 2 Absence of fetal movements by palpation or visualisation.
2.3
2.3. Analysis
Comparison 2 Fetal vibroacoustic stimulation versus mock stimulation, Outcome 3 Mean testing time for modified biophysical profile.
2.4
2.4. Analysis
Comparison 2 Fetal vibroacoustic stimulation versus mock stimulation, Outcome 4 Fetal distress within 7 days.
2.5
2.5. Analysis
Comparison 2 Fetal vibroacoustic stimulation versus mock stimulation, Outcome 5 False positive in prediction of fetal distress within 7 days.
2.6
2.6. Analysis
Comparison 2 Fetal vibroacoustic stimulation versus mock stimulation, Outcome 6 False negative in prediction of fetal distress within 7 days.
2.7
2.7. Analysis
Comparison 2 Fetal vibroacoustic stimulation versus mock stimulation, Outcome 7 Perinatal deaths.
3.1
3.1. Analysis
Comparison 3 Fetal vibroacoustic stimulation versus manual stimulation, Outcome 1 Non‐reactive cardiotocography.
3.2
3.2. Analysis
Comparison 3 Fetal vibroacoustic stimulation versus manual stimulation, Outcome 2 Need for contraction stress test.
3.3
3.3. Analysis
Comparison 3 Fetal vibroacoustic stimulation versus manual stimulation, Outcome 3 Perinatal deaths.
4.1
4.1. Analysis
Comparison 4 Intermittent vibroacoustic stimulation versus single vibroacoustic stimulation, Outcome 1 Mean testing time for reactive tests.
5.1
5.1. Analysis
Comparison 5 Fetal vibroacoustic stimulation versus light stimulation, Outcome 1 Non‐reactive cardiotocography test.
5.2
5.2. Analysis
Comparison 5 Fetal vibroacoustic stimulation versus light stimulation, Outcome 2 Perinatal deaths.
5.3
5.3. Analysis
Comparison 5 Fetal vibroacoustic stimulation versus light stimulation, Outcome 3 Impairment of fetal hearing.
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Update of

References

References to studies included in this review

Bolnick 2006 {published data only}
    1. Bolnick J, Garcia G, Fletcher B, Rayburn W. Cross‐over trial of fetal heart rate response to external light and vibroacoustic stimulation [abstract]. American Journal of Obstetrics and Gynecology 2004;191(6 Suppl 1):S150.
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Smith 1986 {published data only}
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Berclaz 1991 {published data only}
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Montan 1992a {published data only}
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Pinette 2005 {published data only}
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Gonzalez 1995 {published data only}
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