Tocolysis in term breech external cephalic version.
نویسندگان
چکیده
OBJECTIVES To study the effect of ritodrine tocolysis on the success of external cephalic version (ECV) and to assess the role of ECV in breech presentation at our centre. MATERIAL AND METHODS A prospective randomized double-blind-controlled trial comparing ritodrine and placebo in ECV of singleton term breech pregnancy at a tertiary hospital. RESULTS Among the 60 patients who were recruited, there was a success rate of 36.7%. Ritodrine tocolysis significantly improved the success rate of ECV (50% vs. 23%; P=0.032). There was a marked effect of ritodrine tocolysis on the ECV success in nulliparae (36.4% vs. 13.0%) and multiparae (87.5% vs. 57.1%). External cephalic version has shown to reduce the rate of cesarean section for breech presentation by 33.5% in our unit. CONCLUSION External cephalic version significantly reduced the rate of cesarean section in breech presentation, and ritodrine tocolysis improved the success of ECV and should be offered to both nulliparous and parous women in the case of term breech presentation.
منابع مشابه
Tocolysis for repeat external cephalic version in breech presentation at term: a randomised, double-blinded, placebo-controlled trial.
BACKGROUND External cephalic version (ECV) reduces the incidence of breech presentation at term and caesarean section for non-cephalic births. Tocolytics may improve success rates, but are time consuming, may cause side effects and have not been proven to alter caesarean section rates. The aim of this trial was to determine whether tocolysis should be used if ECV is being re-attempted after a f...
متن کاملExternal cephalic version with epidural anaesthesia after failure of a first trial with beta-mimetics.
OBJECTIVE To assess the efficacy, tolerance, and cost of external version under epidural anaesthesia and beta-mimetic tocolysis after the failure of an initial attempt with tocolysis alone. DESIGN Prospective open study. PARTICIPANTS Sixty-eight women with breech presentation at around 36 weeks of gestation and an attempted external cephalic version under salbutamol that failed, who consent...
متن کاملPrediction of Success in External Cephalic Version under Tocolysis: Still a Challenge.
INTRODUCTION External cephalic version is a procedure of fetal rotation to a cephalic presentation through manoeuvres applied to the maternal abdomen. There are several prognostic factors described in literature for external cephalic version success and prediction scores have been proposed, but their true implication in clinical practice is controversial. We aim to identify possible factors tha...
متن کاملA prospective randomised controlled trial of external cephalic version comparing two methods of uterine tocolysis with a non-tocolysis group.
The use of tocolvtic agents to enhance uterine relaxation and facilitate external cephalic version (ECV) has come under recent debate. We studied 90 breech presentations in late pregnancy who did not have contra-indications to ECV. The patients were randomised into 3 groups of 30 patients each: one was administered oral salbutamol 4 mg t.d.s.; another had intravenous salbutamol infused until th...
متن کاملManagement of Term Breech Presentation and External Cephalic Version
Breech presentation occurs in 3 to 4% of all term pregnancies [1]. Vaginal breech delivery rate has declined significantly since the Term Breech Trial, which showed lower serious perinatal mortality and neonatal morbidity after planned caesarean section delivery at term [1]. External cephalic version (ECV) is proven effective to prevent vaginal breech births and Caesarean sections [2]. The fetu...
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ورودعنوان ژورنال:
- International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
دوره 88 1 شماره
صفحات -
تاریخ انتشار 2005