Central Neuraxial Blockade-Assisted External Cephalic Version in Reducing Caesarean Section Rate Systematic Review and Meta-Analysis英文文献资料.docVIP

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Central Neuraxial Blockade-Assisted External Cephalic Version in Reducing Caesarean Section Rate Systematic Review and Meta-Analysis英文文献资料.doc

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Central Neuraxial Blockade-Assisted External Cephalic Version in Reducing Caesarean Section Rate Systematic Review and Meta-Analysis英文文献资料

HindawiPublishingCorporation ObstetricsandGynecologyInternational Volume2009,ArticleID718981,8pages doi:10.1155/2009/718981 ReviewArticle CentralNeuraxialBlockade-Assisted ExternalCephalicVersioninReducingCaesareanSectionRate: SystematicReviewandMeta-Analysis IbrahimBolaji 1andLillianAlabi-Isama 1,2 1 FamilyServicesDivision,DepartmentofObstetricsandGynaecology,HullYorkMedicalSchool(HYMS), DianaPrincessofWalesHospital,NorthernLincolnshireandGooleHospitalsNHSFoundationTrust, ScarthoRoad,GrimsbyDN332BA,UK 2 ClinicalResearchFellow,DivisionofSurgery,Oncology,ReproductiveBiologyandAnaesthetics,ImperialCollege, HammersmithCampus,DucaneRoad,LondonW120NN,UK CorrespondenceshouldbeaddressedtoIbrahimBolaji,iibolaji@ Received14September2009;Accepted18November2009 RecommendedbyAnthonyO.Odibo Wereviewthemedicalliteratureonthesuccess,safetyandeconomicvalueofcentralneuraxialblockade-assisted(CNB)external cephalicversionfromrandomizedcontrolledstudiesidenti?edfrom1951to2009.Theresultshowedthatmorewomenhad successfulECVwithregionalanaesthesiawithcorrespondingreductionincaesareansectionrate.Theywere1.5timesmorelikely thanwomennotreceivinganaesthesiatohaveasuccessfulECV.Thenumbertotreatissixwomenneededtoreceiveanaesthesia for1babytobeturnedfrombreechtocephalicpresentation.Feto-maternalmorbiditywasnotincreasedintheCNB-aidedgroup consistingofonlytransientbradycardia.Althoughtheappropriateamountofforceforsafeversionhasnotbeenquanti?ed,there wasnoreportofuterinerupturedespiteremovalofthesepatientsfrom“excessiveforce-painbiofeedbackloop”inducedthrough motornerveblockade.Wecanattribute30%ofcostsavingsamountingto￡42,150.00directlytoCNBusingthemostuptodate HealthResourceGroupCode(HRG4).Theinitialresultsareencouragingbutuntilthebene?tsandsafetyofCNB-aidedECVare substantiatedbylargerandomized,blindedcontrolledtrials,thispracticecannotbeuniversallyrecommended. Copyright?2009I.BolajiandL.Alabi-Isama.ThisisanopenaccessarticledistributedundertheCreativeCommonsAttribution License,whichpermitsunrestr