central neuraxial blockade-assisted external cephalic version in reducing caesarean section rate systematic review and meta-analysis中央轴索的blockade-assisted外部头版本在降低剖腹产率系统回顾和荟萃分析.pdfVIP

Hindawi Publishing Corporation Obstetrics and Gynecology International Volume 2009, Article ID 718981, 8 pages doi:10.1155/2009/718981 Review Article Central Neuraxial Blockade-Assisted External Cephalic Version in Reducing Caesarean Section Rate: Systematic Review and Meta-Analysis Ibrahim Bolaji1 and Lillian Alabi-Isama1, 2 1 Family 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, UK 2 Clinical Research Fellow, Division of Surgery, Oncology, Reproductive Biology and Anaesthetics, Imperial College, Hammersmith Campus, Du cane Road, London W120NN, UK Correspondence should be addressed to Ibrahim Bolaji, iibolaji@ Received 14 September 2009; Accepted 18 November 2009 Recommended by Anthony O. Odibo 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 bloc