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Related Experiment Video

Updated: Sep 29, 2025

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

External cephalic version: Success rates with and without nitrous oxide.

Thoa K Ha¹, Robyn Lamar², Cinthia Blat²

¹Division of Maternal-Fetal Medicine, Department of Gynecology and Obstetrics, Emory School of Medicine, Atlanta, GA, United States.

European Journal of Obstetrics, Gynecology, and Reproductive Biology

|March 22, 2022

Summary

Nitrous oxide did not significantly change the success rate of external cephalic version (ECV) in converting breech to head-down presentation. This study found no difference in ECV success or vaginal delivery rates with or without nitrous oxide use.

Keywords:

Anesthesia Breech presentation Cesarean External cephalic version Malpresentation Nitrous oxide Non vertex Obstetrics Vaginal delivery

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Recording Brain Electromagnetic Activity During the Administration of the Gaseous Anesthetic Agents Xenon and Nitrous Oxide in Healthy Volunteers

Recording Brain Electromagnetic Activity During the Administration of the Gaseous Anesthetic Agents Xenon and Nitrous Oxide in Healthy Volunteers

Published on: January 13, 2018

Area of Science:

Obstetrics and Gynecology
Maternal-Fetal Medicine
Pain Management in Labor

Background:

External cephalic version (ECV) is a procedure to reduce cesarean deliveries caused by fetal malpresentation.
Nitrous oxide, an inhaled analgesic, is sometimes used for pain relief during ECV.
The efficacy of nitrous oxide in improving ECV outcomes is not well-established.

Purpose of the Study:

To compare the success rates of ECV in converting non-cephalic to cephalic presentations.
To evaluate the impact of nitrous oxide use on ECV conversion rates.
To assess the effect of nitrous oxide on the rate of vaginal delivery following ECV.

Main Methods:

Retrospective cohort analysis of singleton, term gestation ECVs from January 2016 to June 2017.
Comparison of ECV success rates between women who received nitrous oxide and those who did not.
Multivariable logistic regression analysis to control for confounding factors.

Main Results:

A total of 167 women underwent ECV (77 with nitrous oxide, 90 without).
Successful conversion rates were similar: 32.5% with nitrous oxide vs. 32.2% without.
After adjusting for confounders, nitrous oxide showed no significant effect on ECV success (OR 1.08, 95% CI 0.52-2.23).

Conclusions:

Nitrous oxide does not appear to influence the conversion rate of non-cephalic to cephalic presentation during ECV.
Further research is recommended to explore nitrous oxide's impact on patient satisfaction and willingness to undergo ECV.
The study did not find a significant difference in vaginal delivery rates between the groups.