Related Experiment Video
Updated: Jun 12, 2026
08:49
External Cephalic Version: Is it an Effective and Safe Procedure?
Published on: June 6, 2020
Effectiveness of epidural anesthesia for external cephalic version (ECV)
M Yoshida1, H Matsuda, Y Kawakami
1Department of Obstetrics and Gynecology, National Defense Medical College, Saitama, Japan. dr22023@ndmc.ac.jp
Summary
Epidural anesthesia significantly improves external cephalic version (ECV) success rates for breech presentations. This study found a higher ECV success rate in patients receiving epidural anesthesia compared to those who did not.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Anesthesiology
Background:
- External cephalic version (ECV) is a procedure to turn a fetus from a non-cephalic to a cephalic presentation.
- Previous reviews suggest ECV is useful, with success rates varying based on anesthesia use.
- Epidural anesthesia is one method explored to enhance ECV success.
Purpose of the Study:
- To evaluate the effectiveness of epidural anesthesia in improving the success rate of external cephalic version.
- To identify factors influencing successful ECV beyond epidural anesthesia.
Main Methods:
- A retrospective cohort study of 86 pregnant women (35-36 weeks gestation) with non-cephalic presentation.
- Comparison of ECV success rates between a group receiving epidural anesthesia and a non-anesthesia group.
- Exclusion criteria included placenta previa, ruptured membranes, uterine anomalies, and fetal anomalies.
Main Results:
- The ECV success rate was 55.9% in the non-anesthesia group (n=34) and 78.8% in the epidural anesthesia group (n=52).
- Epidural anesthesia use was associated with a significantly higher success rate (odds ratio 1.75, 95% CI 1.26-2.44).
- No other tested factors (age, parity, BMI, placental location) significantly predicted ECV success.
Conclusions:
- Epidural anesthesia significantly increases the success rate of external cephalic version for breech presentation.
- The findings support the use of epidural anesthesia as an effective adjunct for ECV.
Related Concept Videos
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
01:16Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...
01:11Local Anesthetics: Clinical Application as Spinal Anesthesia
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
01:30Electroconvulsive Therapy
Electroconvulsive therapy (ECT), or shock therapy, remains a critical biomedical intervention for severe, treatment-resistant depression. While its origins can be traced back to Hippocrates' observations that malaria-induced convulsions alleviated mental illness, modern ECT has evolved significantly from its earlier, more primitive applications. First introduced in 1938 by Ugo Cerletti and his colleagues, ECT involves inducing controlled seizures using electrical currents. In its early years,...