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Marjolein Kok - One of the best experts on this subject based on the ideXlab platform.
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risk factors for cesarean section and instrumental vaginal delivery after successful External Cephalic Version
Journal of Maternal-fetal & Neonatal Medicine, 2016Co-Authors: Marcella De Hundt, Ben Willem J. Mol, Joke M. Bais, Floortje Vlemmix, Christianne J M De Groot, Marjolein KokAbstract:Aim of this article is to examine if we could identify factors that predict cesarean section and instrumental vaginal delivery in women who had a successful External Cephalic Version. We used data from a previous randomized trial among 25 hospitals and their referring midwife practices in the Netherlands. With the data of this trial, we performed a cohort study among women attempting vaginal delivery after successful ECV. We evaluated whether maternal age, gestational age, parity, time interval between ECV and delivery, birth weight, neonatal gender, and induction of labor were predictive for a vaginal delivery on one hand or a CS or instrumental vaginal delivery on the other hand. Unadjusted and adjusted odds ratios were calculated with univariate and multivariate logistic regression analysis. Among 301 women who attempted vaginal delivery after a successful External Cephalic Version attempt, the cesarean section rate was 13% and the instrumental vaginal delivery rate 6%, resulting in a combined instrumental delivery rate of 19%. Nulliparity increased the risk of cesarean section (OR 2.7 (95% CI 1.2-6.1)) and instrumental delivery (OR 4.2 (95% CI 2.1-8.6)). Maternal age, gestational age at delivery, time interval between External Cephalic Version and delivery, birth weight and neonatal gender did not contribute to the prediction of failed spontaneous vaginal delivery. In our cohort of 301 women with a successful External Cephalic Version, nulliparity was the only one of seven factors that predicted the risk for cesarean section and instrumental vaginal delivery.
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External Cephalic Version-Related Risks
2008Co-Authors: Kim Grootscholten, Marjolein Kok, S. Guid Oei, Ben Willem J. Mol, Joris A. M. Van Der PostAbstract:OBJECTIVE: To systematically review the literature on ex-ternal Cephalic Version–related complications and to assessif the outcome of a Version attempt is related to complica-tions.DATA SOURCES: In March 2007 we searched MEDLINE,EMBASE, and the Cochrane Central Register of Con-trolled Trials.METHODS OF STUDY SELECTION: Studies reporting oncomplicationsfromanExternalCephalicVersionattemptforsingleton breech pregnancies after 36 weeks of pregnancywereselected.Wecalculatedoddsratios(ORs)fromstudiesthat reported both on complications as well as on theposition of the fetus immediately after the procedure.TABULATION, INTEGRATION, AND RESULTS: Wefound 84 studies, reporting on 12,955 Version attemptsthat reported on External Cephalic Version–related com-plications. The pooled complication rate was 6.1% (95%CI 4.7–7.8), 0.24% for serious complications (95% confi-dence interval [CI] 0.17–0.34) and 0.35% for emergencycesarean deliveries (95% CI 0.26–0.47). Complicationswere not related to External Cephalic Version outcome(OR 1.2 (95% CI 0.93–1.7).CONCLUSION: External Cephalic Version is a safe pro-cedure. Complications are not related to the fetal posi-tion after External Cephalic Version.
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Nifedipine as a Uterine Relaxant for External Cephalic Version
Obstetrics & Gynecology, 2008Co-Authors: Marjolein Kok, Joke M. Bais, Jan M. Van Lith, Dimitri M. Papatsonis, Gunilla Kleiverda, Dahrs Hanny, Johannes P. Doornbos, Ben W. Mol, Joris A. Van Der PostAbstract:OBJECTIVE: To estimate the effectiveness of nifedipine as a uterine relaxant during External Cephalic Version to correct breech presentation. METHODS: In this randomized, double-blind, placebo-controlled trial, women with a singleton fetus in breech presentation and a gestational age of 36 weeks or more were eligible for enrollment. Participating women received two doses of either nifedipine 10 mg or placebo, 30 and 15 minutes before the External Cephalic Version attempt. The primary outcome was a Cephalic-presenting fetus immediately after the procedure. Secondary outcome measures were Cephalic presentation at delivery, mode of delivery, and adverse events. A sample size of 292 was calculated to provide 80% power to detect a 17% improvement of the External Cephalic Version success rate, assuming a placebo group rate of 40% and alpha of .05. RESULTS: Outcome data for 310 of 320 randomly assigned participants revealed no significant difference in External Cephalic Version success rates between treatment (42%) and control group (37%) (relative risk 1.1, 95%; 95% confidence interval 0.85–1.5). The cesarean delivery rate was 51% in the treatment group and 46% in the control group (relative risk 1.1, 95% confidence interval 0.88–1.4). CONCLUSION: Nifedipine did not significantly improve the success of External Cephalic Version. Future use of nifedipine to improve the outcome of External Cephalic Version should be limited to large clinical trials.Marjolein Kok, Joke M. Bais, Jan M. van Lith, Dimitri M. Papatsonis, Gunilla Kleiverda, Dahrs Hanny, Johannes P. Doornbos, Ben W. Mol and Joris A. van der Pos
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Nifedipine as a uterine relaxant for External Cephalic Version: a randomized controlled trial.
Obstetrics & Gynecology, 2008Co-Authors: Marjolein Kok, Ben Willem J. Mol, Joke M. Bais, Jan M. Van Lith, Dimitri M. Papatsonis, Gunilla Kleiverda, Dahrs Hanny, Johannes P. Doornbos, Joris A. M. Van Der PostAbstract:OBJECTIVE: To estimate the effectiveness of nifedipine as a uterine relaxant during External Cephalic Version to correct breech presentation. METHODS: In this randomized, double-blind, placebo-controlled trial, women with a singleton fetus in breech presentation and a gestational age of 36 weeks or more were eligible for enrollment. Participating women received two doses of either nifedipine 10 mg or placebo, 30 and 15 minutes before the External Cephalic Version attempt. The primary outcome was a Cephalic-presenting fetus immediately after the procedure. Secondary outcome measures were Cephalic presentation at delivery, mode of delivery, and adverse events. A sample size of 292 was calculated to provide 80% power to detect a 17% improvement of the External Cephalic Version success rate, assuming a placebo group rate of 40% and alpha of .05. RESULTS: Outcome data for 310 of 320 randomly assigned participants revealed no significant difference in External Cephalic Version success rates between treatment (42%) and control group (37%) (relative risk 1.1, 95%; 95% confidence interval 0.85-1.5). The cesarean delivery rate was 51% in the treatment group and 46% in the control group (relative risk 1.1, 95% confidence interval 0.88-1.4). CONCLUSION: Nifedipine did not significantly improve the success of External Cephalic Version. Future use of nifedipine to improve the outcome of External Cephalic Version should be limited to large clinical trials.
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Nifedipine as a uterine relaxant for External Cephalic Version: a randomized controlled trial.
Obstetrics and gynecology, 2008Co-Authors: Marjolein Kok, Joke M. Bais, Jan M. Van Lith, Dimitri M. Papatsonis, Gunilla Kleiverda, Dahrs Hanny, Johannes P. Doornbos, Ben W. Mol, Joris A. Van Der PostAbstract:To estimate the effectiveness of nifedipine as a uterine relaxant during External Cephalic Version to correct breech presentation. In this randomized, double-blind, placebo-controlled trial, women with a singleton fetus in breech presentation and a gestational age of 36 weeks or more were eligible for enrollment. Participating women received two doses of either nifedipine 10 mg or placebo, 30 and 15 minutes before the External Cephalic Version attempt. The primary outcome was a Cephalic-presenting fetus immediately after the procedure. Secondary outcome measures were Cephalic presentation at delivery, mode of delivery, and adverse events. A sample size of 292 was calculated to provide 80% power to detect a 17% improvement of the External Cephalic Version success rate, assuming a placebo group rate of 40% and alpha of .05. Outcome data for 310 of 320 randomly assigned participants revealed no significant difference in External Cephalic Version success rates between treatment (42%) and control group (37%) (relative risk 1.1, 95%; 95% confidence interval 0.85-1.5). The cesarean delivery rate was 51% in the treatment group and 46% in the control group (relative risk 1.1, 95% confidence interval 0.88-1.4). Nifedipine did not significantly improve the success of External Cephalic Version. Future use of nifedipine to improve the outcome of External Cephalic Version should be limited to large clinical trials.
Marc Boucher - One of the best experts on this subject based on the ideXlab platform.
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External Cephalic Version among women with a previous cesarean delivery: report on 36 cases and review of the literature.
Journal of perinatal medicine, 2009Co-Authors: Haim A. Abenhaim, Jocelyne Varin, Marc BoucherAbstract:Aims: Whether or not women with a previous cesarean section should be considered for an External Cephalic Version remains unclear. In our study, we sought to examine the relationship between a history of previous cesarean section and outcomes of External Cephalic Version for pregnancies at 36 completed weeks of gestation or more. Methods: Data on obstetrical history and on External Cephalic Version outcomes was obtained from the C.H.U. Sainte-Justine External Cephalic Version Database. Baseline clinical characteristics were compared among women with and without a history of previous cesarean section. We used logistic regression analysis to evaluate the effect of previous cesarean section on success of External Cephalic Version while adjusting for parity, maternal body mass index, gestational age, estimated fetal weight, and amniotic fluid index. Results: Over a 15-year period, 1425 External Cephalic Versions were attempted of which 36 (2.5%) were performed on women with a previous cesarean section. Although women with a history of previous cesarean section were more likely to be older and para >2 (38.93% vs. 15.0%), there were no difference in gestational age, estimated fetal weight, and amniotic fluid index. Women with a prior cesarean section had a success rate similar to women without [50.0% vs. 51.6%, adjusted OR: 1.31 (0.48-3.59)]. Conclusion: Women with a previous cesarean section who undergo an External Cephalic Version have similar success rates than do women without. Concern about procedural success in women with a previous cesarean section is unwarranted and should not deter attempting an External Cephalic Version.
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Fetomaternal hemorrhage during External Cephalic Version.
Obstetrics and gynecology, 2008Co-Authors: Marc Boucher, Gerald P. Marquette, Jocelyne Varin, Josette Champagne, Emmanuel BujoldAbstract:OBJECTIVE: To estimate the frequency and volume of fetomaternal hemorrhage during External Cephalic Version for term breech singleton fetuses and to identify risk factors involved with this complication. METHODS: A prospective observational study was performed including all patients undergoing a trial of External Cephalic Version for a breech presentation of at least 36 weeks of gestation between 1987 and 2001 in our center. A search for fetal erythrocytes using the standard Kleihauer-Betke test was obtained before and after each External Cephalic Version. The frequency and volume of fetomaternal hemorrhage were calculated. Putative risk factors for fetomaternal hemorrhage were evaluated by chi(2) test and Mann-Whitney U test. RESULTS: A Kleihauer-Betke test result was available before and after 1,311 trials of External Cephalic Version. The Kleihauer-Betke test was positive in 67 (5.1%) before the procedure. Of the 1,244 women with a negative Kleihauer-Betke test before External Cephalic Version, 30 (2.4%) had a positive Kleihauer-Betke test after the procedure. Ten (0.8%) had an estimated fetomaternal hemorrhage greater than 1 mL, and one (0.08%) had an estimated fetomaternal hemorrhage greater than 30 mL. The risk of fetomaternal hemorrhage was not influenced by parity, gestational age, body mass index, number of attempts at Version, placental location, or amniotic fluid index. CONCLUSION: The risk of detectable fetomaternal hemorrhage during External Cephalic Version was 2.4%, with fetomaternal hemorrhage more than 30 mL in less than 0.1% of cases. These data suggest that the performance of a Kleihauer-Betke test is unwarranted in uneventful External Cephalic Version and that in Rh-negative women, no further Rh immune globulin is necessary other than the routine 300-microgram dose at 28 weeks of gestation and postpartum. LEVEL OF EVIDENCE: II.
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Sublingual nitroglycerin versus placebo as a tocolytic for External Cephalic Version: a randomized controlled trial in parous women.
American journal of obstetrics and gynecology, 2003Co-Authors: Emmanuel Bujold, Marc Boucher, D Rinfret, Susan Berman, Ema Ferreira, Gerald P. MarquetteAbstract:Abstract Objective The purpose of this study was to evaluate the efficacy of sublingual nitroglycerin as a tocolytic agent for External Cephalic Version in parous women. Study design A double-blinded randomized controlled trial was performed. Patients with parity of ≥1 at 36 to 40 weeks of gestation who were eligible for External Cephalic Version were included. Patients were randomized to receive either two sublingual sprays of 400 μg of nitroglycerin or two sprays of placebo 3 minutes before the trial of External Cephalic Version. Rates of successful External Cephalic Version and side effects were compared between groups. Results Of 99 patients in the study, 50 patients received sublingual nitroglycerin, and 49 patients received placebo. There were no differences in maternal age, gestational age, estimated fetal weight, amniotic fluid index, and placental location between the two groups. The success rate of External Cephalic Version was 48% in the nitroglycerin group compared with 63% in the placebo group ( P =.13). There was a higher incidence of headaches in the nitroglycerin group (42% vs 4%, P Conclusion Sublingual nitroglycerin was associated with a higher rate of headache and did not improve the rate of successful External Cephalic Version.
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Does the use of a tocolytic agent affect the success rate of External Cephalic Version
American Journal of Obstetrics and Gynecology, 1996Co-Authors: Gerald P. Marquette, Marc Boucher, D Thériault, D RinfretAbstract:Abstract OBJECTIVE: Our purpose was to study the effect of ritodrine tocolysis on the success rate of External Cephalic Version at ≥36 weeks' gestation. STUDY DESIGN: This was a prospective, double-blinded, randomized study. All patients were at ≥36 weeks' gestation, confirmed by early ultrasonography. External Cephalic Version assessment included nonstress testing before and after External Cephalic Version and ultrasonographic evaluation of type of breech, estimated fetal weight, position of placenta and fetal spine, and amniotic fluid index. Patients were excluded if the breech was not mobile or if they had any contraindications to tocolysis or External Cephalic Version. After randomization 283 patients received either ritodrine (111 μg/min) or identical placebo by intravenous infusion for ≥20 minutes. Up to three attempts at External Cephalic Version under ultrasonographic surveillance were performed. With an α error of 0.05 and a β of 0.2, 264 patients were required to complete this study. RESULTS: There were no differences between study groups in maternal age, body mass index, gestational age, amniotic fluid index, position of fetal spine, and placental location. Statistical analysis controlled for parity because parity had a major influence on success rates. There was a higher success rate in the group receiving ritodrine tocolysis (52% vs 42%, p = 0.028). Ritodrine improved success rates in nulliparous patients (43% vs 25%, p = 0.026) but not in parous subjects (66% vs 58%, p = 0.385). CONCLUSION: Ritodrine tocolysis improves the success rate of External Cephalic Version performed at ≥36 weeks in nulliparous patients. (Am J Obstet Gynecol 1996;175:859-61.)
Joris A. M. Van Der Post - One of the best experts on this subject based on the ideXlab platform.
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External Cephalic Version-Related Risks
2008Co-Authors: Kim Grootscholten, Marjolein Kok, S. Guid Oei, Ben Willem J. Mol, Joris A. M. Van Der PostAbstract:OBJECTIVE: To systematically review the literature on ex-ternal Cephalic Version–related complications and to assessif the outcome of a Version attempt is related to complica-tions.DATA SOURCES: In March 2007 we searched MEDLINE,EMBASE, and the Cochrane Central Register of Con-trolled Trials.METHODS OF STUDY SELECTION: Studies reporting oncomplicationsfromanExternalCephalicVersionattemptforsingleton breech pregnancies after 36 weeks of pregnancywereselected.Wecalculatedoddsratios(ORs)fromstudiesthat reported both on complications as well as on theposition of the fetus immediately after the procedure.TABULATION, INTEGRATION, AND RESULTS: Wefound 84 studies, reporting on 12,955 Version attemptsthat reported on External Cephalic Version–related com-plications. The pooled complication rate was 6.1% (95%CI 4.7–7.8), 0.24% for serious complications (95% confi-dence interval [CI] 0.17–0.34) and 0.35% for emergencycesarean deliveries (95% CI 0.26–0.47). Complicationswere not related to External Cephalic Version outcome(OR 1.2 (95% CI 0.93–1.7).CONCLUSION: External Cephalic Version is a safe pro-cedure. Complications are not related to the fetal posi-tion after External Cephalic Version.
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Nifedipine as a uterine relaxant for External Cephalic Version: a randomized controlled trial.
Obstetrics & Gynecology, 2008Co-Authors: Marjolein Kok, Ben Willem J. Mol, Joke M. Bais, Jan M. Van Lith, Dimitri M. Papatsonis, Gunilla Kleiverda, Dahrs Hanny, Johannes P. Doornbos, Joris A. M. Van Der PostAbstract:OBJECTIVE: To estimate the effectiveness of nifedipine as a uterine relaxant during External Cephalic Version to correct breech presentation. METHODS: In this randomized, double-blind, placebo-controlled trial, women with a singleton fetus in breech presentation and a gestational age of 36 weeks or more were eligible for enrollment. Participating women received two doses of either nifedipine 10 mg or placebo, 30 and 15 minutes before the External Cephalic Version attempt. The primary outcome was a Cephalic-presenting fetus immediately after the procedure. Secondary outcome measures were Cephalic presentation at delivery, mode of delivery, and adverse events. A sample size of 292 was calculated to provide 80% power to detect a 17% improvement of the External Cephalic Version success rate, assuming a placebo group rate of 40% and alpha of .05. RESULTS: Outcome data for 310 of 320 randomly assigned participants revealed no significant difference in External Cephalic Version success rates between treatment (42%) and control group (37%) (relative risk 1.1, 95%; 95% confidence interval 0.85-1.5). The cesarean delivery rate was 51% in the treatment group and 46% in the control group (relative risk 1.1, 95% confidence interval 0.88-1.4). CONCLUSION: Nifedipine did not significantly improve the success of External Cephalic Version. Future use of nifedipine to improve the outcome of External Cephalic Version should be limited to large clinical trials.
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External Cephalic Version-related risks: a meta-analysis.
Obstetrics and gynecology, 2008Co-Authors: Kim Grootscholten, Marjolein Kok, S. Guid Oei, Ben Willem J. Mol, Joris A. M. Van Der PostAbstract:OBJECTIVE:To systematically review the literature on External Cephalic Version–related complications and to assess if the outcome of a Version attempt is related to complications.DATA SOURCES:In March 2007 we searched MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials.METHODS OF
G J Hofmeyr - One of the best experts on this subject based on the ideXlab platform.
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interventions to help External Cephalic Version for breech presentation at term
Cochrane Database of Systematic Reviews, 2004Co-Authors: G J HofmeyrAbstract:BACKGROUND Breech presentation places a fetus at increased risk. The outcome for the baby is improved by planned caesarean section compared with planned vaginal delivery. External Cephalic Version attempt reduces the chance of breech presentation at birth, but is not always successful. Tocolytic drugs to relax the uterus as well as other methods have been also used in an attempt to facilitate External Cephalic Version at term. OBJECTIVES The objective of this review is to assess the effects of routine tocolysis, fetal acoustic stimulation, epidural or spinal analgesia and transabdominal amnioinfusion for External Cephalic Version at term on successful Version and measures of pregnancy outcome. SEARCH STRATEGY The Cochrane Pregnancy and Childbirth Group Trials Register (searched December 2001) and the Cochrane Controlled Trials Register (The Cochrane Library, Issue 4, 2001) were searched. SELECTION CRITERIA Randomised and quasi-randomised trials comparing routine versus selective or no tocolysis; fetal acoustic stimulation in midline fetal spine positions versus dummy or no stimulation; epidural or spinal analgesia versus no regional analgesia; or transabdominal amnioinfusion versus no amnioinfusion for External Cephalic Version at term. DATA COLLECTION AND ANALYSIS Eligibility and trial quality were assessed by the reviewer. MAIN RESULTS In six trials, routine tocolysis was associated with fewer failures of External Cephalic Version (relative risk 0.74, 95% confidence interval 0.64 to 0.87). The reduction in non-Cephalic presentations at birth was not statistically significant. Caesarean sections were reduced (relative risk 0.85, 95% confidence interval 0.72 to 0.99). Fetal acoustic stimulation in midline fetal spine positions was associated with fewer failures of External Cephalic Version at term (relative risk 0.17, 95% confidence interval 0.05 to 0.60). With epidural or spinal analgesia, External Cephalic Version failure, non-Cephalic births and caesarean sections were reduced in two trials but not the other. The overall differences were not statistically significant. No randomised trials of transabdominal amnioinfusion for External Cephalic Version at term were located. REVIEWER'S CONCLUSIONS Routine tocolysis appears to reduce the failure rate of External Cephalic Version at term. Although promising, there is not enough evidence to evaluate the use of fetal acoustic stimulation in midline fetal spine positions, nor of epidural or spinal analgesia. Large volume intravenous preloading may have contributed to the effectiveness demonstrated in two of the latter trials. No randomised trials of transabdominal amnioinfusion for External Cephalic Version at term were found.
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External Cephalic Version facilitation for breech presentation at term
Cochrane Database of Systematic Reviews, 2001Co-Authors: G J HofmeyrAbstract:Background Tocolytic drugs to relax the uterus as well as other methods have been also used in an attempt to facilitate External Cephalic Version at term. Objectives The objective of this review is to assess the effects of routine tocolysis, fetal acoustic stimulation, epidural or spinal analgesia and transabdominal amnioinfusion for External Cephalic Version at term on successful Version and measures of pregnancy outcome. Search strategy The Cochrane Pregnancy and Childbirth Group Trials Register and the Cochrane Controlled Trials Register were searched. Date of last search: April 2001. Selection criteria Randomised and quasi-randomised trials comparing routine versus selective tocolysis; fetal acoustic stimulation in midline fetal spine positions versus dummy or no stimulation; epidural or spinal analgesia versus no regional analgesia; or transabdominal amnioinfusion versus no amnioinfusion for External Cephalic Version at term. Data collection and analysis Eligibility and trial quality were assessed by the reviewer. Main results In seven trials, routine tocolysis was associated with fewer failures of External Cephalic Version (relative risk 0.74, 95% confidence interval 0.64 to 0.87). There were no significant differences between non-Cephalic presentations at birth. Caesarean sections were reduced (relative risk 0.85, confidence interval 0.72-0.99). Fetal acoustic stimulation in midline fetal spine positions was associated with fewer failures of External Cephalic Version at term (relative risk 0.17, 95% confidence interval 0.05 to 0.60). With epidural or spinal analgesia, External Cephalic Version failure, non-Cephalic births and caesarean sections were reduced in one trial but not the other. The overall differences were not statistically significant. No randomised trials of transabdominal amnioinfusion for External Cephalic Version at term were located. Reviewer's conclusions Routine tocolysis appears to reduce the failure rate of External Cephalic Version at term. Although promising, there is not enough evidence to evaluate the use of fetal acoustic stimulation in midline fetal spine positions, nor of epidural or spinal analgesia. Large volume intravenous preloading may have contributed to the effectiveness demonstrated in one of the latter trials. No randomised trials of transabdominal amnioinfusion for External Cephalic Version at term were found.
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External Cephalic Version facilitation for breech presentation at term.
The Cochrane database of systematic reviews, 2000Co-Authors: G J HofmeyrAbstract:Successful External Cephalic Version at a late stage of pregnancy was considered to be possible only with the use of tocolytic drugs to relax the uterus. Other methods are also used in an attempt to facilitate External Cephalic Version at term. The objective of this review was to assess the effects of routine tocolysis, fetal acoustic stimulation, epidural anaesthesia and transabdominal amnioinfusion for External Cephalic Version at term on successful Version and measures of pregnancy outcome. The Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register were searched. Date of last search: February 1999. Randomised and quasi-randomised trials comparing routine versus selective tocolysis; fetal acoustic stimulation in midline fetal spine positions versus dummy or no stimulation; epidural analgesia versus no epidural analgesia; or transabdominal amnioinfusion versus no amnioinfusion for External Cephalic Version at term. Eligibility and trial quality were assessed by the reviewer. Six trials were included. Routine tocolysis was associated with fewer failures of External Cephalic Version (relative risk 0.77, 95% confidence interval 0.64 to 0.92). There were no significant differences between non-Cephalic presentations and caesarean sections. Fetal acoustic stimulation in midline fetal spine positions was associated with fewer failures of External Cephalic Version at term (relative risk 0.17, 95% confidence interval 0.05 to 0.60). No randomised trials of epidural analgesia or transabdominal amnioinfusion for External Cephalic Version at term were located. Routine tocolysis appears to reduce the failure rate of External Cephalic Version at term. Although promising, there is not enough evidence to evaluate the use of fetal acoustic stimulation in midline fetal spine positions. There is not enough evidence to evaluate the use of epidural analgesia or transabdominal amnioinfusion for External Cephalic Version at term.
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External Cephalic Version at term
Fetal and Maternal Medicine Review, 1993Co-Authors: G J HofmeyrAbstract:It is remarkable that, for all the sophistication of current obstetric practice, uncertainty should persist concerning the management of as fundamental a problem as breech presentation, particularly with respect to the place of External Cephalic Version (ECV). This review will focus on information available for guiding clinical decisions, and practical aspects of the procedure.
Wendy Saurenman Giles - One of the best experts on this subject based on the ideXlab platform.
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External Cephalic Version after previous cesarean section.
American journal of obstetrics and gynecology, 1991Co-Authors: Bruce L. Flamm, Marc W. Fried, Neal M. Lonky, Wendy Saurenman GilesAbstract:Approximately 100,000 cesarean sections are performed each year in the United States because of breech presentation. Numerous studies have shown that External Cephalic Version can eliminate the need for many of these operations. However, because of the fear of uterine rupture, these studies have generally excluded patients who have undergone previous cesarean section. To evaluate the validity of this exclusion policy, we studied patients with one or more previous cesarean sections and breech presentations near term. Version attempts were successful in 82% of 56 patients who had undergone a previous cesarean section. Sixty-five percent of the successful Version patients went on to have vaginal birth after cesarean section. There were no serious maternal or fetal complications associated with the Version attempts. We conclude that External Cephalic Version is a reasonable option in patients with prior low transverse cesarean section.
