Does Bed Rest Improve Outcome of Pregnancy?
Researchers Find Answer Isn't Clear for Women With High Blood Pressure
Do Risks Outweigh Benefits? continued...
The researchers were part of the Cochrane Collaborative, an international, nonprofit organization that conducts systematic reviews of current medical practices.
Meher points out that in addition to having no obvious benefit, there are potential risks and clear disadvantages to putting pregnant woman on bed rest.
Long-term immobility is associated with an increased risk of blood clots, and involuntary bed rest is likely to add stress to an already stressful pregnancy. And women who work suffer economically, Meher says.
"Because of these potential negative effects, I think there should be better evidence before bed rest is recommended to women," she says.
Pennsylvania ob-gyn John T. Repke, MD, agrees that there is a paucity of clinical evidence showing that bed rest improves pregnancy outcomes in women with hypertension. But he adds that bed rest clearly reduces daily fluctuations in blood pressure, which may have an impact on outcomes.
"The bottom line is that we still recommend bed rest to many, many women who have blood pressure disorders or mild preeclampsia, to flatten out blood pressure throughout the day," he says.
"It makes sense that this should make a difference, but we don't know with certainty that it will change outcomes one iota."
Repke says he is careful to explain this to his bed-rest patients so that they don't feel that they are to blame if something bad happens.
He is chairman of the department of obstetrics and gynecology at Penn State College of Medicine-Milton S. Hershey Medical Center and is the former president of the North American Society for the Study of Hypertension in Pregnancy.
"Human nature being what it is, a woman who doesn't comply fully may feel guilty when there is an unfortunate outcome," he says. "We don't want patients to think it was their fault because they got up and did the ironing or went to the bathroom."