Related Experiment Videos
Epidural analgesia for cephalic version: a randomized trial
K M Mancuso1, M K Yancey, J A Murphy
1Department of Obstetrics and Gynecology, Tripler Army Medical Center, Honolulu, Hawaii, USA.
Obstetrics and Gynecology
|April 25, 2000
Summary
Epidural analgesia significantly increases the success rate of external cephalic version (ECV) in breech presentations. This intervention also improved the likelihood of achieving a vaginal delivery, offering a benefit for pregnant individuals.
Area of Science:
- Obstetrics and Gynecology
- Anesthesiology
- Perinatal Medicine
Background:
- External cephalic version (ECV) is a procedure to manually turn a fetus from a non-vertex to a vertex presentation.
- Success rates for ECV can be variable, and interventions to improve outcomes are of clinical interest.
Purpose of the Study:
- To evaluate the efficacy of epidural analgesia in improving the success rate of external cephalic version.
- To assess the impact of epidural analgesia on the rate of subsequent vaginal delivery.
Main Methods:
- A randomized trial was conducted involving women at least 37 weeks gestation with singleton non-vertex fetuses.
- Participants were randomized to receive either lumbar epidural analgesia (lidocaine and fentanyl) or no anesthesia during the ECV procedure.
- External cephalic version attempts were performed under ultrasound guidance.
Main Results:
- Epidural analgesia was associated with a significantly higher success rate for ECV (59% vs. 33%, P <.05).
- The rate of successful vaginal delivery was also significantly higher in the epidural group (54% vs. 30%, P <.05).
- No significant differences were observed in gestational age, estimated fetal weight, or other demographic factors between groups.
Conclusions:
- Epidural analgesia enhances the success rate of external cephalic version.
- The use of epidural analgesia during ECV increases the probability of a vaginal birth.