The Effect Of Epidural Anesthesia On Safety And Success Of External Cephalic Version At Term
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Effectiveness of nitrous oxide in external cephalic version
Introduction: Approximately 4% of singleton pregnancies at term are in breech pres - entation. External cephalic version (ECV) can reduce the risks of noncephalic birth and cesarean delivery, but this maneuver can be painful. Our aim was to analyze the effect of administering inhaled nitrous oxide for analgesia on the ECV success rate.
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Controversy exists as to which neuraxial technique (spinal, epidural or CSE) and drug (local anesthetic and/or opioid) are optimal for ECV success. Studies suggest that local anesthetics in anesthetic rather than analgesic doses may be necessary to improve the success of ECV.
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shown to reduce cesarean birth rates. External cephalic version for breech presentation and a trial of labor for women with twin gestations when the first twin is in cephalic presentation are other of several examples of interventions that can contribute to the safe lowering of the primary cesarean delivery rate. 11
Nitrous Oxide Analgesia for External Cephalic Version: A
It is recommended to offer external cephalic version (ECV), a maneuver to turn the fetus from breech to cephalic position, when possible to avoid cesarean delivery 2 Although ECV is typically a brief procedure, it is associated with a moderate amount of pain 3
Use of Nitrous Oxide in Maternity Care: AWHONN Practice Brief
the effect. Similarly, the gas is eliminated from the lungs quickly within a few breaths (Rooks, 2011). Viable option during procedures when regional anesthesia is not in use (e.g., external cephalic version, manual removal of placenta, perineal repair). No adverse effect on uterine activity; N 2O will not decrease frequency or intensity of
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the success rate of external fetal version: a meta-analysis. Can J Anaesth. 2010;57:408-414. 33. Cherayil G, Feinberg B, Robinson J, et al. Central neuraxial blockade promotes external cephalic version success after a failed attempt. Anesth Analg. 2002;94:1589-1592. 34. Deprest JA, Devlieger R, Srisupundit K, et al. Fetal surgery is a clinical
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shown to reduce cesarean birth rates. External cephalic version for breech presentation and a trial of labor for women with twin gestations when the first twin is in cephalic presentation are other of several examples of interventions that can contributeto the safe lowering of the primary cesarean delivery rate. 9
State of the breech in 2020: Guidelines support maternal
cesarean will have a large downstream effect on the overall ce-sarean rate. External cephalic version (ECV) can potentially prevent about half of these cesareans34,35 and appears to be more readily available than planned vaginal breech delivery; however, its use is limited by maternity care providers failing