A randomized trial of epidural anesthesia to improve external cephalic version success

Objective: This study was designed to determine whether epidural anesthesia would improve external cephalic version success in a safe and effective manner. Study Design: All women >37 weeks' gestation with breech presentation scheduled for external cephalic version at the medical center from Dec. 1, 1993, to July 31, 1996, were randomized to receive an epidural or no epidural anesthesia. Under ultrasonographic guidance up to three version attempts were performed. Results: Sixty-nine women were randomized to receive epidural ( n = 35) versus no epidural ( n = 34) anesthesia for external cephalic version. There were no statistically significant differences in maternal age, parity, maternal weight, gestational age, estimated fetal weight, or station of the presenting part. The success rate was better for the epidural group (relative risk 2.12, 95% confidence interval 1.24 to 3.62). Neither anterior placentation or oligohydramnios affected the success rate. Conclusion: Epidural anesthesia increases success of external cephalic version without any apparent detrimental effect on the maternal-fetal unit.