Fetal acoustic stimulation, an adjunct to external cephalic version: a blinded, randomized crossover study

Area of Science:

• Obstetrics and Gynecology
• Fetal Medicine
• Perinatal Research

Background:

• External cephalic version (ECV) is a procedure to turn a fetus from a breech to a cephalic presentation.
• Fetal malpresentation, particularly breech presentation, is a common indication for Cesarean delivery.
• Effective methods to improve ECV success rates are crucial for reducing Cesarean births.

Purpose of the Study:

• To investigate the efficacy of fetal acoustic stimulation in enhancing the success rate of external cephalic version.
• To determine if acoustic stimulation can facilitate fetal position changes in fetuses with midline spine presentations at term.

Main Methods:

• A randomized, blinded crossover trial (N-of-1 design) was conducted.
• Patients served as their own controls, comparing acoustic stimulation to the maternal abdomen versus a control (acoustic stimulation to the arm).
• Fetal position was assessed, and ECV success was recorded for each condition.

Main Results:

• Fetal acoustic stimulation to the maternal abdomen resulted in 100% of fetuses shifting to a spine lateral position and 92% successful ECV.
• The control group showed no position changes and only a 9% ECV success rate (p < 0.0001).
• Combined data showed an 86% ECV success rate with acoustic stimulation versus 8% with placebo (p < 0.0001).

Conclusions:

• Fetal acoustic stimulation is an effective method to encourage fetal position changes.
• This intervention significantly increases the success rate of external cephalic version in fetuses with midline spine presentations.
• Acoustic stimulation offers a promising, non-invasive approach to improve ECV outcomes.