A RANDOMIZED TRIAL OF EPIDURAL-ANESTHESIA TO IMPROVE EXTERNAL CEPHALIC VERSION SUCCESS

OBJECTIVE: This study was designed to determine whether epidural anest hesia would improve external cephalic version success in a safe and ef fective manner. STUDY DESIGN: All women >37 weeks' gestation with bree ch presentation scheduled for external cephalic version at the medical center from Dec. 1, 1993, to July 31, 1996, were randomized to receiv e an epidural or no epidural anesthesia. Under ultrasonographic guidan ce up to three version attempts were performed. RESULTS: Sixty-nine wo men were randomized to receive epidural (n = 35) versus no epidural (n = 34) anesthesia for external cephalic version. There were no statist ically significant differences in maternal age, parity, maternal weigh t, gestational age, estimated fetal weight, or station of the presenti ng part. The success rate was better for the epidural group (relative risk 2.12, 95% confidence interval 1.24 to 3.62). Neither anterior pla centation or oligohydramnios affected the success rate. CONCLUSION: Ep idural anesthesia increases success of external cephalic version witho ut any apparent detrimental effect on the maternal-fetal unit.