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Amnioinfusion to facilitate external cephalic version after initial failure

P N Adama van Scheltema, A H Feitsma, J M Middeldorp, F P H A Vandenbussche, D Oepkes
Obstetrics and Gynecology 2006, 108 (3): 591-2

OBJECTIVE: To evaluate the effectiveness of antepartum transabdominal amnioinfusion to facilitate external cephalic version after initial failure.

METHODS: Women with a structurally normal fetus in breech lie at term, with a failed external cephalic version and an amniotic fluid index (AFI) less than 15 cm, were asked to participate in our study. After tocolysis with indomethacin, a transabdominal amnioinfusion was performed with an 18G spinal needle. Lactated Ringers solution was infused until the AFI reached 15 cm, with a maximum of 1 L. External cephalic version was performed directly afterward.

RESULTS: Seven women participated in the study. The gestational age of the women was between 36(+4) and 38(+3) weeks, and three women were primiparous. The AFI ranged from 4 cm to 13 cm. A median amount of 1,000 mL Ringers solution (range 700-1,000 mL) was infused per procedure. The repeat external cephalic versions after amnioinfusion were not successful in any of the patients.

CONCLUSION: In our experience, amnioinfusion does not facilitate external cephalic version.

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