Sedation with Propofol plus Paracetamol in External Cephalic Version: An Observational Study.

Area of Science:

• Obstetrics and Gynecology
• Anesthesiology
• Perinatology

Background:

• External cephalic version (ECV) is a procedure to turn a fetus from a breech to a cephalic presentation before labor.
• Neuraxial anesthesia and remifentanil are commonly used for ECV, but propofol's efficacy has not been analyzed.
• Understanding alternative anesthetic options is crucial for improving ECV success rates and patient safety.

Purpose of the Study:

• To evaluate the outcomes of external cephalic version (ECV) when propofol is used as the primary sedative agent.
• To determine the success rate of achieving cephalic presentation and subsequent delivery modes.
• To assess the safety and complication rates associated with propofol use during ECV.

Main Methods:

• An observational analysis of 131 pregnant women undergoing ECV between January 2018 and December 2020.
• ECV was performed with tocolysis and propofol sedation.
• Data collected included propofol dosage, ECV success, delivery outcomes, and complications.

Main Results:

• Cephalic presentation was achieved in 61.1% (80/131) of women.
• Among those with cephalic presentation at labor, 56.7% had spontaneous delivery, 26.9% had operative delivery, and 16.4% required intrapartum cesarean section.
• The emergency cesarean section rate within 24 hours was 10.7%, and major ECV complications occurred in 11.5% of cases.

Conclusions:

• External cephalic version (ECV) using propofol sedation demonstrates outcomes comparable to other anesthetic adjuncts.
• Propofol appears to be an adequate and potentially effective option for ECV procedures.
• Further research is warranted to directly compare propofol's effectiveness against neuraxial techniques in ECV.