Related Experiment Video
Updated: May 25, 2026
08:49
External Cephalic Version: Is it an Effective and Safe Procedure?
Published on: June 6, 2020
Interventions for helping to turn term breech babies to head first presentation when using external cephalic version
Catherine Cluver1, G Justus Hofmeyr, Gillian Ml Gyte
1Department of Obstetrics and Gynaecology, Faculty of Health Sciences, Stellenbosch Universityand Tygerberg Hospital, PO Box 19063, Tygerberg, Western Cape, 7505, South Africa. cathycluver@hotmail.com.
The Cochrane Database of Systematic Reviews
|January 20, 2012
Summary
Betastimulants facilitate external cephalic version (ECV) for breech presentation, increasing cephalic births and reducing C-sections. Further research is needed on tocolysis benefits and risks.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Clinical Trials and Evidence Synthesis
Background:
- Breech presentation at term is associated with increased obstetric complications.
- External cephalic version (ECV) aims to convert breech to cephalic presentation before birth.
- Interventions like tocolysis are used to facilitate ECV success.
Purpose of the Study:
- To assess the effectiveness of interventions (tocolysis, fetal acoustic stimulation, regional analgesia, amnioinfusion, opioids) in facilitating ECV for term breech presentation.
- To evaluate the impact of these interventions on ECV success rates and birth outcomes.
Main Methods:
- Systematic review and meta-analysis of randomized and quasi-randomized controlled trials.
- Searched Cochrane Pregnancy and Childbirth Group's Trials Register and reference lists.
- Included 25 studies with 2548 women, assessing eligibility and trial quality independently.
Main Results:
- Betastimulant tocolysis increased cephalic presentation in labor (RR 1.38) and reduced caesarean sections (RR 0.82).
- Regional analgesia combined with tocolysis improved successful ECV rates (RR 0.67) but did not significantly alter labor presentation or C-section rates.
- Insufficient data existed for fetal acoustic stimulation, amnioinfusion, and systemic opioids; no significant difference in fetal bradycardia was noted with tocolysis.
Conclusions:
- Betamimetics are recommended to facilitate ECV, improving cephalic presentation and reducing C-sections.
- Further research is warranted on the benefits and risks of tocolysis, and the role of regional analgesia and other adjuncts.
- Limited evidence suggests nitroglycerine is not effective for facilitating ECV.
Related Concept Videos
01:11Anatomical Positions
In anatomy, several standard anatomical positions are used as references for describing the position and orientation of different body parts. These positions help provide a common frame of reference when discussing anatomical structures. The anatomical position is the standard reference point for describing the body's position and orientation. In this position:
The body is upright, facing forward, and standing erect.
The feet are parallel and flat on the floor.
The arms are hanging by the...
The body is upright, facing forward, and standing erect.
The feet are parallel and flat on the floor.
The arms are hanging by the...
01:22Cardiopulmonary 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...
01:30Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques
Airway management is essential in emergency and surgical medicine, ensuring ventilation and oxygenation in patients who cannot maintain their own airway. Clinicians use a range of techniques and devices to secure the airway, depending on the patient’s condition and the clinical context. Key methods include endotracheal intubation, rapid sequence intubation (RSI), supraglottic airway devices, and advanced visualization aids. In cases where these approaches fail, surgical airway interventions are...
01:15Endotracheal Intubation I: Procedure
Endotracheal or ET intubation is a critical medical procedure used to secure a patient's airway, often in acute respiratory distress, apnea, upper airway obstruction, ineffective clearance of secretions, high risk for aspiration, or during general anesthesia.
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...