Clinical outcomes after external cephalic version with spinal anesthesia after failure of a first attempt without anesthesia. Issue 3 (22nd September 2017)

• Record Type: Journal Article
• Authors: Massalha, Manal; Garmi, Gali; Zafran, Noah; Carmeli, Julia; Gimburg, Genady; Salim, Raed
• Is Part Of: International journal of gynaecology and obstetrics. Volume 139:Issue 3(2017)
• Page Start: 324
• Page End: 328
• Publication Date: 2017-09-22
• Subjects: Breech presentation -- Cesarean delivery -- External cephalic version -- Spinal anesthesia; Gynecology -- Periodicals; Obstetrics -- Periodicals; Electronic journals; 618
• DOI: 10.1002/ijgo.12312
• Languages: English
• ISSNs: 0020-7292

Abstract

Abstract: Objective: To determine whether repeat external cephalic version (ECV) with spinal anesthesia affects clinical outcomes and cesarean delivery rates. Methods: A retrospective study was conducted using data collected at one hospital in Israel between January 1, 2009, and December 31, 2015. Women with non‐vertex singleton pregnancies (≥37 weeks) who had a failed ECV attempt without spinal anesthesia were included in the analysis. All women were offered a repeat ECV with spinal anesthesia. Outcomes assessed were rates of vertex presentation at delivery, successful repeat ECV, and cesarean delivery. Results: Overall, 145 of 213 ECV attempts without spinal anesthesia were successful. Of the 68 women with a failed attempt, 5 (7%) experienced spontaneous version and 18 (26%) delivered at another institution or went into spontaneous labor. Among the remaining 45 women, 28 (62%) agreed to a repeat ECV with spinal anesthesia; 11 (39%) of these procedures were successful. All 11 women experienced vertex presentation at delivery versus none of the 17 women who refused repeat ECV ( P =0.003). The cesarean delivery rate was 64% (18/28) versus 100% (17/17), respectively ( P =0.007). Conclusion: Repeat ECV with spinal anesthesia after a failed first attempt without spinal anesthesia increased vertex presentation at birth and decreased the rate of cesarean delivery. Abstract : Repeat external cephalic version with spinal anesthesia after first attempt failure increased the frequency of vertex presentation at birth and decreased the cesarean delivery rate.