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  1. Nifedipine versus terbutaline for tocolysis in external cephalic version
    Mohamed Ismail NA, Ibrahim M, Mohd Naim N, Mahdy ZA, Jamil MA, Mohd Razi ZR
    Int J Gynaecol Obstet, 2008 Sep;102(3):263-6.
    PMID: 18554601 DOI: 10.1016/j.ijgo.2008.04.010
    To study the efficacy of nifedipine compared with terbutaline as a tocolytic agent in external cephalic version (ECV).
    Matched MeSH terms: Breech Presentation/therapy
  2. Intravenous salbutamol for external cephalic version
    Vani S, Lau SY, Lim BK, Omar SZ, Tan PC
    Int J Gynaecol Obstet, 2009 Jan;104(1):28-31.
    PMID: 18922525 DOI: 10.1016/j.ijgo.2008.08.014
    To evaluate the success of external cephalic version (ECV) using an adjusted bolus dose of intravenous salbutamol compared with no tocolysis.
    Matched MeSH terms: Breech Presentation/therapy*
  3. Fulltext Oral nifepidine versus subcutaneous terbutaline tocolysis for external cephalic version: a double-blind randomised trial
    Collaris R, Tan PC
    BJOG, 2009 Jan;116(1):74-80; discussion 80-1.
    PMID: 19087079 DOI: 10.1111/j.1471-0528.2008.01991.x
    To evaluate oral nifedipine versus subcutaneous terbutaline tocolysis for external cephalic version (ECV).
    Matched MeSH terms: Breech Presentation/therapy
  4. Fulltext Talcum powder or aqueous gel to aid external cephalic version: a randomised controlled trial
    Vallikkannu N, Nadzratulaiman WN, Omar SZ, Si Lay K, Tan PC
    BMC Pregnancy Childbirth, 2014 Jan 28;14:49.
    PMID: 24468078 DOI: 10.1186/1471-2393-14-49
    BACKGROUND: External cephalic version (ECV) is offered to reduce the number of Caesarean delivery indicated by breech presentation which occurs in 3-4% of term pregnancies. ECV is commonly performed aided by the application of aqueous gel or talcum powder to the maternal abdomen. We sought to compare gel with powder during ECV on achieving successful version and increasing tolerability.

    METHOD: We enrolled 95 women (≥ 36 weeks gestation) on their attendance for planned ECV. All participants received terbutaline tocolysis. Regional anaesthesia was not used. ECV was performed in the standard fashion after the application of the allocated aid. If the first round (maximum of 2 attempts) of ECV failed, crossover to the opposing aid was permitted.

    RESULTS: 48 women were randomised to powder and 47 to gel. Self-reported procedure related median [interquartile range] pain scores (using a 10-point visual numerical rating scale VNRS; low score more pain) were 6 [5-9] vs. 8 [7-9] P = 0.03 in favor of gel. ECV was successful in 21/48 (43.8%) vs. 26/47 (55.3%) RR 0.6 95% CI 0.3-1.4 P = 0.3 for powder and gel arms respectively. Crossover to the opposing aid and a second round of ECV was performed in 13/27 (48.1%) following initial failure with powder and 4/21 (19%) after failure with gel (RR 3.9 95% CI 1.0-15 P = 0.07). ECV success rate was 5/13 (38.5%) vs. 1/4 (25%) P = 0.99 after crossover use of gel or powder respectively. Operators reported higher satisfaction score with the use of gel (high score, greater satisfaction) VNRS scores 6 [4.25-8] vs 8 [7-9] P = 0.01.

    CONCLUSION: Women find gel use to be associated with less pain. The ECV success rate is not significantly different.

    TRIAL REGISTRATION: The trial is registered with ISRCTN (identifier ISRCTN87231556).

    Matched MeSH terms: Breech Presentation/therapy*
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