Central Neuraxial Blockade-Assisted External Cephalic Version in Reducing Caesarean Section Rate: Systematic Review and Meta-Analysis
We review the medical literature on the success, safety and economic value of central neuraxial blockade-assisted (CNB) external cephalic version from randomized controlled studies identified from 1951 to 2009. The result showed that more women had successful ECV with regional anaesthesia with corre...
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| Format: | Article |
| Language: | English |
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Wiley
2009-01-01
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| Series: | Obstetrics and Gynecology International |
| Online Access: | http://dx.doi.org/10.1155/2009/718981 |
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| _version_ | 1849410149602557952 |
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| author | Ibrahim Bolaji Lillian Alabi-Isama |
| author_facet | Ibrahim Bolaji Lillian Alabi-Isama |
| author_sort | Ibrahim Bolaji |
| collection | DOAJ |
| description | We review the medical literature on the success, safety and economic value of central neuraxial blockade-assisted (CNB) external cephalic version from randomized controlled studies identified from 1951 to 2009. The result showed that more women had successful ECV with regional anaesthesia with corresponding reduction in caesarean section rate. They were 1.5 times more likely than women not receiving anaesthesia to have a successful ECV. The number to treat is six women needed to receive anaesthesia for 1 baby to be turned from breech to cephalic presentation. Feto-maternal morbidity was not increased in the CNB-aided group consisting of only transient bradycardia. Although the appropriate amount of force for safe version has not been quantified, there was no report of uterine rupture despite removal of these patients from “excessive force-pain biofeedback loop” induced through motor nerve blockade. We can attribute 30% of cost savings amounting to £42,150.00 directly to CNB using the most up to date Health Resource Group Code (HRG4). The initial results are encouraging but until the benefits and safety of CNB-aided ECV are substantiated by large randomized, blinded controlled trials, this practice cannot be universally recommended. |
| format | Article |
| id | doaj-art-80aaa6d9514b4eaeae35bf7b28287711 |
| institution | Kabale University |
| issn | 1687-9589 1687-9597 |
| language | English |
| publishDate | 2009-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Obstetrics and Gynecology International |
| spelling | doaj-art-80aaa6d9514b4eaeae35bf7b282877112025-08-20T03:35:14ZengWileyObstetrics and Gynecology International1687-95891687-95972009-01-01200910.1155/2009/718981718981Central Neuraxial Blockade-Assisted External Cephalic Version in Reducing Caesarean Section Rate: Systematic Review and Meta-AnalysisIbrahim Bolaji0Lillian Alabi-Isama1Family Services Division, Department of Obstetrics and Gynaecology, Hull York Medical School (HYMS), Diana Princess of Wales Hospital, Northern Lincolnshire and Goole Hospitals NHS Foundation Trust, Scartho Road, Grimsby DN33 2BA, UKFamily Services Division, Department of Obstetrics and Gynaecology, Hull York Medical School (HYMS), Diana Princess of Wales Hospital, Northern Lincolnshire and Goole Hospitals NHS Foundation Trust, Scartho Road, Grimsby DN33 2BA, UKWe review the medical literature on the success, safety and economic value of central neuraxial blockade-assisted (CNB) external cephalic version from randomized controlled studies identified from 1951 to 2009. The result showed that more women had successful ECV with regional anaesthesia with corresponding reduction in caesarean section rate. They were 1.5 times more likely than women not receiving anaesthesia to have a successful ECV. The number to treat is six women needed to receive anaesthesia for 1 baby to be turned from breech to cephalic presentation. Feto-maternal morbidity was not increased in the CNB-aided group consisting of only transient bradycardia. Although the appropriate amount of force for safe version has not been quantified, there was no report of uterine rupture despite removal of these patients from “excessive force-pain biofeedback loop” induced through motor nerve blockade. We can attribute 30% of cost savings amounting to £42,150.00 directly to CNB using the most up to date Health Resource Group Code (HRG4). The initial results are encouraging but until the benefits and safety of CNB-aided ECV are substantiated by large randomized, blinded controlled trials, this practice cannot be universally recommended.http://dx.doi.org/10.1155/2009/718981 |
| spellingShingle | Ibrahim Bolaji Lillian Alabi-Isama Central Neuraxial Blockade-Assisted External Cephalic Version in Reducing Caesarean Section Rate: Systematic Review and Meta-Analysis Obstetrics and Gynecology International |
| title | Central Neuraxial Blockade-Assisted External Cephalic Version in Reducing Caesarean Section Rate: Systematic Review and Meta-Analysis |
| title_full | Central Neuraxial Blockade-Assisted External Cephalic Version in Reducing Caesarean Section Rate: Systematic Review and Meta-Analysis |
| title_fullStr | Central Neuraxial Blockade-Assisted External Cephalic Version in Reducing Caesarean Section Rate: Systematic Review and Meta-Analysis |
| title_full_unstemmed | Central Neuraxial Blockade-Assisted External Cephalic Version in Reducing Caesarean Section Rate: Systematic Review and Meta-Analysis |
| title_short | Central Neuraxial Blockade-Assisted External Cephalic Version in Reducing Caesarean Section Rate: Systematic Review and Meta-Analysis |
| title_sort | central neuraxial blockade assisted external cephalic version in reducing caesarean section rate systematic review and meta analysis |
| url | http://dx.doi.org/10.1155/2009/718981 |
| work_keys_str_mv | AT ibrahimbolaji centralneuraxialblockadeassistedexternalcephalicversioninreducingcaesareansectionratesystematicreviewandmetaanalysis AT lillianalabiisama centralneuraxialblockadeassistedexternalcephalicversioninreducingcaesareansectionratesystematicreviewandmetaanalysis |