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Fulltext Successful external cephalic version: factors predicting vaginal birth

Lim PS, Ng BK, Ali A, Shafiee MN, Kampan NC, Mohamed Ismail NA, et al.

ScientificWorldJournal, 2014;2014:860107.

PMID: 24587759 DOI: 10.1155/2014/860107

To determine the maternal and fetal outcomes of successful external cephalic version (ECV) as well as factors predicting vaginal birth.

Matched MeSH terms: Version, Fetal/methods*

Outcome of external cephalic version: our experience

Teoh T

J Obstet Gynaecol Res, 1996 Aug;22(4):389-94.

PMID: 8870425

The aim is to assess the outcome of external cephalic version (ECV) for term breech in our clinical setting and the factors involved. Patients with no contraindications and who consented to ECV were recruited into this prospective study. Terbutalin infusion was used. There were 42 ECV attempts of which 21 (50%) were successful. Seventeen of the patients with successful ECV delivered vaginally and 4 had cesarean section for various indications. Only 5 of the 21 unsuccessful ECV delivered vaginally. Thirteen had elective cesarean section and 2 had emergency cesarean during trial of breech. One patient from the unsuccessful ECV group was lost to follow-up. There were 31 (74%) primipara. The birth weight of the babies was not a significant factor in the outcome of ECV. The type of breech and parity did influence the success rate. External cephalic version should be included in the routine management of our breech presentation.

Matched MeSH terms: Version, Fetal/methods*

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: Version, Fetal/methods*

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: Version, Fetal/methods*

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: Version, Fetal/methods*

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