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Related Experiment Video

Updated: Jun 20, 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 nitroglycerin for external cephalic version: a randomized controlled trial.

Jennifer Hilton1, Bruce Allan, Cheryl Swaby

  • 1From the Departments of Obstetrics and Gynecology, Community Health Sciences, and Family Medicine, University of Calgary, Calgary Health Region, Calgary, Alberta, Canada.

Obstetrics and Gynecology
|August 25, 2009
PubMed
Summary
This summary is machine-generated.

Intravenous nitroglycerin improved external cephalic version success in nulliparous women. This treatment did not significantly benefit multiparous women but appeared safe in both groups.

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Area of Science:

  • Obstetrics and Gynecology
  • Pharmacology
  • Clinical Trials

Background:

  • External cephalic version (ECV) is a procedure to turn a fetus from a breech to a cephalic presentation before labor.
  • Uterine relaxation may improve ECV success rates, and nitroglycerin is a potential tocolytic agent.

Purpose of the Study:

  • To evaluate the efficacy and safety of intravenous nitroglycerin for uterine relaxation during ECV.

Main Methods:

  • Two double-blind, randomized clinical trials were conducted in nulliparous and multiparous women undergoing ECV.
  • The primary outcome was the immediate success rate of ECV.
  • Secondary outcomes included presentation at delivery, cesarean delivery rate, and adverse events.

Main Results:

  • In nulliparous women, ECV success was significantly higher in the nitroglycerin group (24%) compared to placebo (8%) (P=.04).
  • In multiparous women, ECV success rates were similar between the nitroglycerin (44%) and placebo (43%) groups (P=.60).
  • Intravenous nitroglycerin was generally well-tolerated, with no significant increase in adverse events reported.

Conclusions:

  • Intravenous nitroglycerin enhances successful ECV in nulliparous women.
  • The benefit of nitroglycerin for ECV was not demonstrated in multiparous women.
  • While appearing safe, larger studies are needed to confirm the safety profile and rule out rare adverse effects.