Fetal acoustic stimulation as an adjunct to external cephalic version.
OBJECTIVE
To evaluate fetal acoustic stimulation (FAS) as an adjunct to external cephalic version in a midline fetal spine presentation.


METHODS
Breech presentation in a woman presenting for attempted version at 37 weeks' gestation with a fetus in a midline position and the spine anterior is difficult to convert to a vertex. An evaluation of FAS to assist in repositioning the fetus in a more spine lateral position was carried out. Patients with a failed version attempt and a midline breech presentation were enrolled in the study. The patient served as her own control. If that attempt failed, an electrolarynx device was used to produce a one- to three-second stimulus, and then another version attempt was made.


RESULTS
Sixteen patients were enrolled. Prior to FAS, 0/16 fetuses were successfully turned. FAS altered the position in 100% of patients from spine midline to lateral. After FAS, 15/16 (94%) were successfully converted to vertex presentation. The one patient whose fetus failed to convert also failed her second version attempt (P < .0005).


CONCLUSIONS
FAS may improve the opportunity for successful external cephalic version in the properly selected candidate with a fetus in a midline position with the spine anterior.
Johnson
R L
RL
Phoenix Perinatal Associates, Good Samaritan Regional Medical Center, Arizona, USA.
Strong
T H
TH
Radin
T G
TG
Elliott
J P
JP
D000161:Acoustic Stimulation / Q000379:methods*; D000293:Adolescent; D000328:Adult; D001946:Breech Presentation; D005260:Female; D005323:Fetal Monitoring; D006801:Humans; D018579:Patient Selection; D011247:Pregnancy; D011379:Prognosis; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal; D014710:Version, Fetal / Q000379:methods* / Q000592:standards