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Related Concept Videos

Cardiopulmonary Resuscitation II: ACLS Airway Management01:22

Cardiopulmonary Resuscitation II: ACLS Airway Management

Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned under...
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Related Experiment Video

Updated: Jun 28, 2026

External Cephalic Version: Is it an Effective and Safe Procedure?
08:49

External Cephalic Version: Is it an Effective and Safe Procedure?

Published on: June 6, 2020

Intravenous salbutamol for external cephalic version.

Subramaniam Vani1, Soon Yen Lau, Boon Kiong Lim

  • 1Department of Obstetrics and Gynecology, Maternity Hospital Penang, Penang, Malaysia.

International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics
|October 17, 2008
PubMed
Summary

Administering intravenous salbutamol before external cephalic version (ECV) significantly increases ECV success rates. This method also effectively reduces the rate of cesarean deliveries in women with breech presentation.

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Last Updated: Jun 28, 2026

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Published on: June 6, 2020

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Pharmacology in Pregnancy

Background:

  • External cephalic version (ECV) is a procedure to turn a fetus from a breech to a cephalic presentation.
  • Tocolysis, the inhibition of uterine contractions, is often used to facilitate ECV.
  • The optimal tocolytic agent and dosage for ECV remain areas of investigation.

Purpose of the Study:

  • To assess the efficacy of an adjusted intravenous bolus dose of salbutamol as a tocolytic agent prior to ECV.
  • To compare the success rate of ECV with salbutamol tocolysis versus no tocolysis.
  • To evaluate the impact of salbutamol on the rate of cesarean delivery.

Main Methods:

  • An open-label randomized controlled study involving 114 women with term breech fetuses.
  • Participants were assigned to receive either intravenous salbutamol boluses before ECV or no tocolysis.
  • Primary outcomes measured were successful ECV and the rate of cesarean delivery.

Main Results:

  • Successful ECV was significantly higher in the salbutamol group (70.2%) compared to the no tocolysis group (36.8%).
  • The rate of cesarean delivery was substantially lower in the salbutamol group (31.6%) versus the control group (63.2%).
  • The effective salbutamol dose ranged from 0.1-0.4 mg, with no observed relationship between dose and outcome.

Conclusions:

  • Pre-procedural intravenous salbutamol tocolysis enhances the success rate of external cephalic version.
  • The use of salbutamol prior to ECV is associated with a reduced rate of cesarean delivery.
  • Adjusted-dose intravenous salbutamol is an effective tocolytic strategy for ECV.