Abstract | OBJECTIVE: METHODS: RESULTS: Seventy-four women were enrolled, and 70 analyzed (36 spinal, 34 no analgesia). Successful external cephalic version occurred among 24 of 36 (66.7%) women randomized to receive spinal analgesia compared with 11 of 34 (32.4%) without, P=.004 (95% confidence interval [CI] of the difference: 0.0954-0.5513). External cephalic version with spinal analgesia resulted in a lower visual analog pain score, 1.76+/-2.74 compared with 6.84+/-3.08 without, P<.001. A secondary analysis logistic regression model demonstrated that the odds of external cephalic version success was 4.0-fold higher when performed with spinal analgesia P=.02 (95% CI, odds ratio [OR] 1.2-12.9). Complete breech presentation before attempting external cephalic version increased the odds of success 8.2-fold, P=.001 (95% CI, OR 2.2-30.3). Placental position, estimated fetal weight, and maternal weight did not contribute to the success rate when spinal analgesia was used. There were no cases of placental abruption or fetal distress. CONCLUSION: Administration of spinal analgesia significantly increases the success rate of external cephalic version among nulliparous women at term, which allows possible normal vaginal delivery. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00119184 LEVEL OF EVIDENCE: I.
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Authors | Carolyn F Weiniger, Yehuda Ginosar, Uriel Elchalal, Einav Sharon, Malka Nokrian, Yossef Ezra |
Journal | Obstetrics and gynecology
(Obstet Gynecol)
Vol. 110
Issue 6
Pg. 1343-50
(Dec 2007)
ISSN: 0029-7844 [Print] United States |
PMID | 18055730
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Topics |
- Adult
- Anesthesia, Spinal
- Breech Presentation
(therapy)
- Female
- Humans
- Pain Measurement
- Parity
- Pregnancy
- Treatment Outcome
- Version, Fetal
(methods)
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