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External Cephalic Version Immediately Before a Caesarean Delivery

Not Applicable
Not yet recruiting
Conditions
Malpresentation Before Labor Affecting Fetus or Newborn
Interventions
Procedure: External cephalic version
Registration Number
NCT05020340
Lead Sponsor
The University of Hong Kong
Brief Summary

Fetal malpresentation at term affects around 5% of pregnancy and breech presentation is the most common type of malpresentation. It is a common indication for a Caesarean delivery. External cephalic version (ECV) refers to turning the fetus manually and aims to increase the success of vaginal birth by reducing the need for Caesarean section.

Detailed Description

Several factors affect the chance of a successful ECV which include multiparity, use of tocolytic and regional anaesthesia during the procedure. Anticipating or not tolerating a painful procedure is another factor that affects the willingness to and success of ECV.

ECV can be reattempted under regional anaesthesia immediately just before the Caesarean section to increase the vaginal birth rate in women who have failed an ECV. Therefore, the aim of this study is to evaluate whether this approach could increase the rate of vaginal birth and reduce the non-cephalic presentation at labour and Caesarean section rate.

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
Female
Target Recruitment
42
Inclusion Criteria
  • All women age ≥ 18 years old
  • Singleton pregnancy
  • Malpresentation
  • Have failed an ECV
  • Pregnant ≥ 37 weeks of gestation
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Exclusion Criteria
  • Condition requiring emergency delivery
  • Other indication for Caesarean section
  • History of antepartum haemorrhage in the past 7 days
  • Oligohydraminos with amniotic fluid index <5cm
  • Intrauterine growth restriction with abnormal fetal Doppler or cardiotocography
  • Rhesus isoimmunization
  • Rupture of membranes
  • Gross fetal anomaly
  • Major uterine anomaly
  • Contraindication or refusal to regional anaesthesia
  • Spontaneous cephalic version on the day of scheduled Caesarean section
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Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
InterventionExternal cephalic versionExternal cephalic version
Primary Outcome Measures
NameTimeMethod
Vaginal birthDelivery

Vaginal birth

Secondary Outcome Measures
NameTimeMethod
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