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Related Experiment Video

Updated: Jan 5, 2026

External Cephalic Version: Is it an Effective and Safe Procedure?

External Cephalic Version: Is it an Effective and Safe Procedure?

Published on: June 6, 2020

Nifedipine versus ritodrine during external cephalic version procedure: a case control study.

Gabriel Levin¹, Yossef Ezra¹, Yishay Weill²

¹Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.

The Journal of Maternal-Fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians

|October 15, 2019

Summary

Ritodrine significantly improved external cephalic version (ECV) success rates compared to nifedipine. This beta-stimulant tocolytic therapy also increased vaginal delivery and reduced cesarean sections, demonstrating its efficacy and safety.

Keywords:

Amniotic fluid index breech external cephalic version nifedipine ritodrine

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Published on: April 28, 2023

Area of Science:

Obstetrics and Gynecology
Maternal-Fetal Medicine
Pharmacology in Pregnancy

Background:

Parenteral beta-stimulant tocolytics are known to enhance external cephalic version (ECV) success rates and decrease cesarean section rates.
Evidence regarding the efficacy of calcium channel blockers, such as nifedipine, for facilitating ECV is limited.
A comparative analysis of nifedipine and ritodrine in ECV is warranted due to the paucity of existing literature.

Purpose of the Study:

To compare the efficacy of nifedipine versus ritodrine in improving external cephalic version (ECV) success rates.
To evaluate the impact of these tocolytics on vaginal and cesarean delivery rates in women undergoing ECV.

Main Methods:

A retrospective case-control study utilizing prospectively collected data from January 2012 to December 2013.
Patients undergoing ECV with either ritodrine or nifedipine tocolysis were compared.
A one-to-one matching strategy based on parity and placental location was employed to control for confounding variables.

Main Results:

The ritodrine group exhibited a significantly higher ECV success rate (82.4%) compared to the nifedipine group (63.5%) (p < .001).
Ritodrine was associated with increased rates of vaginal delivery (86.5% vs. 68.9%) and reduced cesarean delivery rates (13.5% vs. 31.1%) compared to nifedipine (p < .001).
Multivariate analysis confirmed ritodrine tocolytic therapy as an independent predictor of higher ECV success rates (OR 4.54).

Conclusions:

Ritodrine significantly enhances external cephalic version success rates when compared with nifedipine.
Both ritodrine and nifedipine were demonstrated to be safe for use as tocolytics during ECV procedures.
The findings support the use of ritodrine for improving ECV outcomes.