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Clinical outcomes after external cephalic version with spinal anesthesia after failure of a first attempt without anesthesia
Author(s) -
Massalha Manal,
Garmi Gali,
Zafran Noah,
Carmeli Julia,
Gimburg Genady,
Salim Raed
Publication year - 2017
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12312
Subject(s) - medicine , spinal anesthesia , cesarean delivery , anesthesia , presentation (obstetrics) , external cephalic version , surgery , pregnancy , breech presentation , biology , genetics
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.