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Updated: May 2, 2026
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External Cephalic Version: Is it an Effective and Safe Procedure?
Published on: June 6, 2020
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Coming out ahead: the cost effectiveness of external cephalic version using spinal anesthesia
James A O'Brien1, Eli Y Adashi
1Women and Infants Hospital of Rhode Island, 101 Dudley Street, Providence, RI 02905, USA. jobrien@wihri.org.
Israel Journal of Health Policy Research
|February 26, 2014
Summary
External cephalic version (ECV) can convert breech to vertex presentation, reducing cesarean births. Regional anesthesia may enhance ECV success and lower costs, though challenges remain.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Anesthesiology
Background:
- Breech presentation occurs in 3-4% of term pregnancies, significantly contributing to cesarean deliveries.
- External cephalic version (ECV) is recommended to reduce cesarean rates in term breech presentations.
- Regional anesthesia is proposed to improve ECV efficacy and cost-effectiveness.
Discussion:
- Obstacles to ECV implementation include patient acceptance, provider experience, and safety concerns.
- Tocolytics and regional anesthesia are explored for secondary ECV attempts to boost success and reduce costs.
- This commentary evaluates the role of regional anesthesia in enhancing ECV procedures.
Key Insights:
- Regional anesthesia can potentially increase the success rate of ECV.
- Implementing regional anesthesia for ECV may lead to reduced healthcare costs.
- Addressing patient and provider concerns is crucial for wider ECV adoption.
Outlook:
- Further research and evidence are needed to overcome implementation barriers for regional anesthesia in ECV.
- Optimizing ECV techniques with regional anesthesia could significantly impact delivery outcomes.
- Exploring combined strategies like tocolytics with regional anesthesia may offer improved success rates.
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