title: Effect of maternal intravenous fluid therapy on external cephalic version at term: a prospective cohort study.
abstract: OBJECTIVE
  We sought to analyze whether maternal intravenous fluid therapy prior to external cephalic version (ECV) increases the amount of amniotic fluid and the success rate of the procedure.
  
  
  METHODS
  This was a prospective single-center cohort study of 200 women with a consecutive cohort of 100 pregnant women with a breech presentation at term who were administered intravenous fluid therapy with 2 L of hypotonic saline before the version attempt, compared to a control cohort of 100 pregnant women not given hydration treatment.
  
  
  RESULTS
  The mean increase in the amniotic fluid index (AFI) after intravenous maternal hydration was 3.75 ± 2.71 cm. The amount of fluid before hydration was the only variable found to be associated with increases in amniotic fluid levels, both in absolute and relative terms (odds ratio, -0.21; 95% confidence interval, -0.37 to -0.05 and odds ratio, -4.62; 95% confidence interval, -6.17 to -3.06; P < .01, respectively). We did not observe any severe complications secondary to the intravenous fluid therapy. The ECV success rate was 43% in the study group compared to 47% in the control group (P = .67). The success rate was significantly lower the larger the relative increase in the AFI, although no correlation was found in absolute terms (χ(2) for linear trend = 0.03 and 0.34, respectively).
  
  
  CONCLUSIONS
  Maternal intravenous fluid therapy with 2 L of hypotonic saline prior to ECV is an effective and safe technique for increasing the AFI. However, its use in ECV does not increase the success rate of the procedure.
authors.affiliation: Obstetrics and Gynecology Service, BioCruces Health Research Institute, Hospital Universitario Cruces (Basque Country University), Biscay, Spain. Electronic address: jburgoss@sego.es.
authors.forename: Jorge
authors.initials: J
authors.lastname: Burgos
authors.affiliation: Obstetrics and Gynecology Service, BioCruces Health Research Institute, Hospital Universitario Cruces (Basque Country University), Biscay, Spain.
authors.forename: Eider
authors.initials: E
authors.lastname: Quintana
authors.affiliation: Obstetrics and Gynecology Service, BioCruces Health Research Institute, Hospital Universitario Cruces (Basque Country University), Biscay, Spain.
authors.forename: Patricia
authors.initials: P
authors.lastname: Cobos
authors.affiliation: Obstetrics and Gynecology Service, BioCruces Health Research Institute, Hospital Universitario Cruces (Basque Country University), Biscay, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Osuna
authors.affiliation: Obstetrics and Gynecology Service, BioCruces Health Research Institute, Hospital Universitario Cruces (Basque Country University), Biscay, Spain.
authors.forename: María del Mar
authors.initials: Mdel M
authors.lastname: Centeno
authors.affiliation: Obstetrics and Gynecology Service, BioCruces Health Research Institute, Hospital Universitario Cruces (Basque Country University), Biscay, Spain.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Melchor
mesh_terms: D000328:Adult; D000653:Amniotic Fluid; D001946:Breech Presentation / Q000628:therapy*; D015331:Cohort Studies; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D007262:Infusions, Intravenous; D011247:Pregnancy; D011446:Prospective Studies; D016896:Treatment Outcome; D014710:Version, Fetal / Q000379:methods*
keywords: amniotic fluid; breech presentation; external cephalic version; maternal hydration