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.