Breech presentation at term Pregnancy and Childbirth Other assisted single delivery
Conditions
Interventions
Women are randomised to 250 µg or 500 µg of bolus subcutaneous terbutaline followed by external cephalic version 15 minutes later with a maximum of two attempts.
Sponsors
University of Malaya Medical Centre (Malaysia)
Eligibility
Sex/Gender
Female
Inclusion criteria
Inclusion criteria: 1. Non-cephalic presentation 2. Singleton pregnancy 3. Gestation greater than or equal to 36 weeks (check for early confirmation of gestational age) 4. Intact membranes 5. Reassuring foetal status on cardiotocograph
Exclusion criteria
Exclusion criteria: 1. Known gross foetal anomaly 2. Severe hypertension (greater than or equal to 160/110 mmHg or confirmed pre-eclampsia) 3. Growth restricted foetus (estimated foetal weight less than 2 kg or ultrasound-derived foetal abdominal circumference less than 10 centile on our chart) 4. Oligohydramnios (amniotic fluid index [AFI] less than 5) 5. Antepartum haemorrhage within last 7 days 6. Uterine scar from any source 7. Known allergy to terbutaline 8. Other potential obstetric indication for caesarean delivery: 8.1. Placenta praevia 8.2. Suspected macrosomia greater than 4 kg 8.3. Uterine anomaly (small fibroids not causing obstruction are acceptable) 8.4. Obstructive pelvic tumour
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1. Immediate success rate of external cephalic version (ECV) 2. Caesarean delivery rate 3. Cephalic presentation at birth All determined by no later than at the birth of the baby. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Post-ECV cardiotocograph abnormalities 2. Neonatal outcomes: 2.1. Neonatal nursery admission 2.2. Apgar score at 5 minutes 2.3. Umbilical cord arterial blood, pH 3. Adverse drug events 4. Visual Analog Scale (VAS) satisfaction score with ECV 5. Indication for operative delivery Determined by no later than hospital discharge following birth. | — |
Countries
Malaysia
Outcome results
None listed