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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
PubMed
Summary
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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.

Related Experiment Videos

  • 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.