Intravenous salbutamol for external cephalic version |
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Authors: | Subramaniam Vani Soon Yen Lau Boon Kiong Lim Siti Zawiah Omar Peng Chiong Tan |
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Affiliation: | Department of Obstetrics and Gynecology, Maternity Hospital Penang, Penang, Malaysia. |
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Abstract: | OBJECTIVE: To evaluate the success of external cephalic version (ECV) using an adjusted bolus dose of intravenous salbutamol compared with no tocolysis. METHODS: An open-label randomized study of 114 women with a term breech fetus randomized to receive either an intravenous bolus dose of 0.1 mg salbutamol with further boluses every 5 minutes, as required, before commencing ECV, or no tocolysis. Primary outcomes were successful ECV and rate of cesarean delivery. RESULTS: Salbutamol tocolysis resulted in a higher rate of successful ECV compared with no tocolysis (70.2% [40/57] vs 36.8% [21/57]; RR 1.9, 95% CI 1.3-2.8; P<0.001). Cesarean delivery rate was lower in the salbutamol group compared with the control group (31.6% [18/57] vs 63.2% [36/57]; RR 0.5, 95% CI 0.3-0.8; P=0.001). Salbutamol dose ranged from 0.1-0.4 mg and outcome was not related to dose. CONCLUSION: Adjusted dose intravenous salbutamol tocolysis prior to ECV increases its success rate and reduces the cesarean delivery rate. |
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Keywords: | Cesarean delivery Breech External cephalic version Salbutamol Tocolysis |
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