Sevoflurane and Success of External Cephalic Version (ECV)
Status:
Not yet recruiting
Trial end date:
2021-10-30
Target enrollment:
Participant gender:
Summary
External cephalic version (ECV) is noninvasive procedure aiming to turn the fetus to cephalic
presentation, thereby enabling vaginal delivery and avoiding unnecessary cesarean delivery.
The American College of Obstetricians and Gynecologists (ACOG) suggested that all women near
term with breech presentation should be offered a version (9). Its success rate depends on
the experience of obstetrician in addition to maternal factors. Several interventions have
been tried to increase the success rate of ECV, including but not limited to tocolytics and
neuraxial anesthesia. Although parenteral β stimulants and spinal anesthesia proved to be
effective for increasing the success rate ECV, their success rates are still not high (10,
11) Sevoflurane's pleasant odor, lack of pungency, and potent bronchodilating characteristics
make sevoflurane administration via the facemask for either sedation or induction of
anesthesia is suitable. Sevoflurane has sedative and uterine relaxation effects all together
would facilitate ECV and consequently would increase its success rate. To the best our
knowledge sevoflurane has never been studied for ECV. Up to 1% concentration of sevoflurane
has been used for labor analgesia without excessive sedation (8). Therefore, the
investigators aim at comparing the success rate of ECV at 36-40 weeks of gestation under 1%
of sevoflurane with a control group (received no anesthetic or other obstetric
interventions). Other outcomes such as pain score and maternal and fetal complications will
also be evaluated.