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Lessons Learned From a Single Institution’s Retrospective Analysis of Emergent Cesarean Delivery Following External Cephalic Version With and Without Neuraxial Anesthesia

Ainsworth, A.; Sviggum, H.P.; Tolcher, M.C.; Weaver, A.L.; Holman, M.A.; Arendt, K.W.

Obstetric Anesthesia Digest: June 2018 - Volume 38 - Issue 2 - p 87–88
doi: 10.1097/01.aoa.0000532282.36214.ce
Mechanisms, Equipment, Hazards

(Int J Obstet Anesth. 2017;31:57–62)

External cephalic version (ECV) has widely variable rates of success (30% to 80%), but, if successful, can prevent cesarean deliveries required due to breech presentation. Previously, the success rate of ECV has been shown to increase by up to 60% with the use of neuraxial anesthesia (NA) during the procedure. Randomized clinical trials comparing ECV with and without NA have reported increased rates of successful ECVs without an increase in emergency cesarean deliveries when NA is used. However, during reviews of internal data, the current authors noted a higher rate of cesarean delivery following ECVs performed with NA versus without at their institution. This retrospective study evaluated whether the randomized clinical trials reflected the realities of clinical practice at their institution.

Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN, Department of Anesthesiology, Mayo Clinic, Rochester, MN

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