Reattempting failed external cephalic version under epidural anesthesia.
OBJECTIVE
We hypothesize that the success rate of external cephalic version may be increased by performing a repeat attempt with the patient under epidural anesthesia.


METHODS
One hundred eight women with term singleton pregnancies in breech presentation underwent attempted external version. When external version failed, we offered them the option of a later attempt under epidural anesthesia. All fetuses who remained in breech position were delivered by elective cesarean section.


RESULTS
Fifty (60%) of the 83 attempted external versions performed without anesthesia were successful. Seventeen of the 33 women whose versions were unsuccessful underwent elective cesarean delivery, and 16 elected to undergo repeat version attempts under epidural. Nine (56%) of these 16 procedures were successful, and 7 of these 9 women were delivered vaginally. The overall success rate was 71%, similar to the success rate of versions attempted on 25 women under epidural anesthesia.


CONCLUSIONS
When an attempted external version fails, a repeat attempt under epidural anesthesia will usually be successful, resulting in a lower cesarean delivery rate.
Neiger
R
R
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Tennessee Medical Center, Knoxville, TN 37920, USA.
Hennessy
M D
MD
Patel
M
M
D000328:Adult; D000767:Anesthesia, Epidural; D000773:Anesthesia, Obstetrical; D001946:Breech Presentation; D002585:Cesarean Section; D005260:Female; D006801:Humans; D011247:Pregnancy; D019233:Retreatment; D017211:Treatment Failure; D016896:Treatment Outcome; D014710:Version, Fetal