Effect of Oral Hydration on External Cephalic Version at Term

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Clinical Trials

Background:

• External cephalic version (ECV) is a procedure to turn breech-presenting fetuses to a cephalic position.
• Optimizing ECV success rates is crucial for reducing cesarean deliveries.
• Amniotic fluid index (AFI) may influence ECV outcomes.

Purpose of the Study:

• To investigate the impact of oral hydration on amniotic fluid index (AFI) and external cephalic version (ECV) success rates.
• To assess the safety and tolerability of oral hydration prior to ECV.

Main Methods:

• A randomized controlled, single-blind trial involving 164 women with term breech presentations and normal AFIs.
• Participants received either 2000 ml (hydration group) or ≤100 ml (control group) of water 2 hours before ECV.
• Amniotic fluid indexes were measured before and after hydration; ECV success and maternal/fetal characteristics were recorded.

Main Results:

• The hydration group showed a significantly higher mean AFI post-treatment compared to the control group (15.5 cm vs. 13.4 cm, p=0.003).
• ECV success rates were 53.7% in the hydration group and 46.3% in the control group (p=0.349), indicating no significant difference.
• Oral hydration was well-tolerated with no serious adverse events reported.

Conclusions:

• Oral hydration effectively increases amniotic fluid index (AFI) in women undergoing external cephalic version (ECV).
• Despite increasing AFI, oral hydration does not significantly enhance the success rate of ECV.
• Further investigation into factors influencing ECV success is warranted.