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Updated: Jul 4, 2026
08:49
External Cephalic Version: Is it an Effective and Safe Procedure?
Published on: June 6, 2020
Nifedipine versus terbutaline for tocolysis in external cephalic version
Nor Azlin Mohamed Ismail1, Maryasalwati Ibrahim, Norzilawati Mohd Naim
1Department of Obstetrics and Gynecology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia. azlinm@mail.hukm.ukm.my
Summary
Nifedipine demonstrated comparable efficacy to terbutaline for external cephalic version (ECV) success, offering a viable alternative tocolytic agent, especially when beta-sympathomimetics are contraindicated.
Area of Science:
- Obstetrics and Gynecology
- Pharmacology
Background:
- External cephalic version (ECV) is a procedure to turn breech presentations to cephalic.
- Tocolytic agents are used to facilitate ECV, with terbutaline being a common choice.
Purpose of the Study:
- To compare the efficacy and safety of nifedipine versus terbutaline as tocolytic agents for ECV.
- To evaluate the success rates and side effect profiles of both agents.
Main Methods:
- A prospective, randomized, comparative trial involving 86 women with singleton term breech pregnancies.
- Participants were randomized to receive either nifedipine or terbutaline for tocolysis prior to ECV in an outpatient setting.
Main Results:
- The overall ECV success rate was 48.8%, reducing cesarean delivery rates for breech presentation by 32.5%.
- ECV success was 39.5% with nifedipine and 58.1% with terbutaline.
- Nifedipine group experienced fewer side effects, though the difference was not statistically significant.
Conclusions:
- Nifedipine is a potential alternative tocolytic agent for ECV.
- It is particularly useful when maternal contraindications to beta-sympathomimetics exist.
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