Nifedipine tocolysis for external cephalic version

Abstract

RCOG guidelines recommend that suitable women with breech presentation at term should be offered external cephalic version (ECV). A meta-analysis published in the Cochrane review suggests that tocolysis improves the success rate of ECV. Oral nifedipine is widely used in tocolysis for preterm labour but has not been evaluated previously as the agent for tocolysis for ECV. This was a double-blind randomised controlled trial of tocolysis for ECV was conducted in a busy teaching hospital in Bristol over 2 years comparing oral nifedipine 30 mg and placebo. Randomisation was stratified by parity. The procedures were performed 30 minutes after giving the drug, by one of five trained operators using a standardised technique. No significant differences were found in baseline characteristics between each group according to parity. The overall success rate was 36%; 20% for primiparous and 57% for multiparous women. There was no significant difference in ECV success rates between those women receiving nifedipine or placebo.