[Ultrasonic convex array probe applied to increase success rate of external cephalic version without anesthesia]

Area of Science:

• Obstetrics and Gynecology
• Medical Ultrasound
• Fetal Medicine

Context:

• External cephalic version (ECV) is a procedure to turn a fetus from a breech to a cephalic presentation before labor.
• Non-cephalic presentations in term and near-term pregnancies pose delivery challenges.
• Anesthesia-free ECV is preferred when feasible.

Purpose:

• To investigate the efficacy of using an ultrasonic convex array probe to compress the abdominal wall during ECV.
• To determine if this technique enhances ECV success rates in term and near-term pregnancies without anesthesia.
• To analyze factors influencing ECV success and associated complications.

Summary:

• A study of 190 pregnant women undergoing ECV found that overall success rate was 64.2%.
• Compressing the abdominal wall with an ultrasound probe significantly increased ECV success in primipara (first-time mothers) but not multipara.
• Positive factors for ECV success in primipara included ultrasound probe compression and higher amniotic fluid index (AFI).
• Transient fetal heart rate reduction was the main complication, occurring more frequently in the probe-compressing group, but no adverse maternal or neonatal outcomes were observed.

Impact:

• Ultrasonic probe compression is a feasible method to improve ECV success rates in primipara.
• This technique does not increase the incidence of adverse maternal and fetal outcomes.
• Amniotic fluid index and the use of probe compression are identified as key factors influencing ECV success in primipara.