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Updated: Dec 31, 2025

External Cephalic Version: Is it an Effective and Safe Procedure?
Published on: June 6, 2020
Atosiban versus ritodrine as tocolytics in external cephalic version
Emilio Couceiro Naveira1, Carlos López Ramón Y Cajal1
1Obstetrics and Gynecology Department, Hospital Álvaro Cunqueiro, Complexo Hospitalario Universitario de Vigo, Vigo, Spain.
Objective:
To assess the efficacy of atosiban versus ritodrine as tocolytics in external cephalic version (ECV).
Materials And Methods:
A prospective comparative trial was carried out in a tertiary hospital. 430 women with singleton breech pregnancies ≥36 weeks were recruited for ECV, 215 with ritodrine and 215 with atosiban as tocolytic agents. The efficacy, complications and perinatal outcomes were compared between both groups. The associations between variables were analyzed using the chi-square test (χ2) (qualitative), Student's t test (quantitative, parametric) or Mann-Whitney test (nonparametric). Statistical significance was established as p < .05.
Results:
The overall ECV success rate was 47.9% (206/430), 46.0% in the atosiban group (99/215) and 49.8% in the ritodrine group (107/215). This difference showed no statistical significance (p = .440). A higher rate of uterine contractions after the maneuver was observed in the atosiban group (34.4 versus 22.8%; p = .008), but without clinical relevance. Perinatal outcomes were similar in both groups, with no significant differences.
Conclusion:
Atosiban and ritodrine showed similar efficacy as tocolytic agents in ECV, with no differences in complications and perinatal outcomes between these two agents.
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