Amnioinfusion to facilitate external cephalic version after initial failure.
OBJECTIVE
To evaluate the effectiveness of antepartum transabdominal amnioinfusion to facilitate external cephalic version after initial failure.


METHODS
Women with a structurally normal fetus in breech lie at term, with a failed external cephalic version and an amniotic fluid index (AFI) less than 15 cm, were asked to participate in our study. After tocolysis with indomethacin, a transabdominal amnioinfusion was performed with an 18G spinal needle. Lactated Ringers solution was infused until the AFI reached 15 cm, with a maximum of 1 L. External cephalic version was performed directly afterward.


RESULTS
Seven women participated in the study. The gestational age of the women was between 36(+4) and 38(+3) weeks, and three women were primiparous. The AFI ranged from 4 cm to 13 cm. A median amount of 1,000 mL Ringers solution (range 700-1,000 mL) was infused per procedure. The repeat external cephalic versions after amnioinfusion were not successful in any of the patients.


CONCLUSIONS
In our experience, amnioinfusion does not facilitate external cephalic version.
Adama van Scheltema
P N
PN
Department of Obstetrics, Leiden University Medical Centre, Leiden, the Netherlands.
Feitsma
A H
AH
Middeldorp
J M
JM
Vandenbussche
F P H A
FP
Oepkes
D
D
D000328:Adult; D000650:Amnion; D001946:Breech Presentation; D036861:Delivery, Obstetric / Q000379:methods*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005865:Gestational Age; D006801:Humans; D007263:Infusions, Parenteral / Q000379:methods; D007552:Isotonic Solutions / Q000008:administration & dosage*; D010298:Parity; D011247:Pregnancy; D011446:Prospective Studies; D000077331:Ringer's Solution; D015145:Tocolysis; D017211:Treatment Failure; D016216:Ultrasonography, Prenatal; D014710:Version, Fetal / Q000379:methods*
D007552:Isotonic Solutions; D000077331:Ringer's Solution