Anesthesia facilitation of external cephalic version: A meta-analysis

Objectives This study was undertaken to systematically review the medical literature to determine whether anesthesia facilitates the external cephalic version maneuver (ECV) for breech presentations. Study design A meta-analytic review of medical databases for randomized clinical trials comparing anesthesia with no anesthesia given for ECV attempts. The primary outcome was the immediate success of the ECV attempt. Results The literature search revealed only 4 articles that met inclusion criteria. Four hundred eighty women participated in the studies and the use of anesthesia increased the success of ECV attempts (119/238 with anesthesia; 82/242 without anesthesia). The relative risk for this beneficial effect was 1.5 (95% CI 1.12-1.98) and number needed to treat was 7 (95% CI 4-14). Conclusion Further study is required to assess maternal and neonatal safety with anesthesia administered for ECV maneuvers.