Nifedipine tocolysis ineffective for external cephalic version

January 01, 0001

Nifedipine tocolysis ineffective for external cephalic version

The success rates of external cephalic version (ECV) are improved with the use of betamimetic tocolytics, but these drugs are associated with maternal side effects. These Australian authors evaluated the effectiveness and advantages, if any, of nifedipine as a tocolytic for ECV. They included randomised trials comparing nifedipine with placebo or another tocolytic agent among women with a singleton, term breech or transverse presentation.

They found: "Three trials met the inclusion criteria. Two trials (n = 176) compared nifedipine with terbutaline and found lower rates of successful ECV among women receiving nifedipine, pooled risk ratio = 0.67. One trial (n = 320) comparing nifedipine with placebo did not find any significant difference in ECV success rates (41.6% nifedipine versus 37.2% placebo). Although minor side effects were slightly higher with nifedipine compared with placebo, there was no significant difference in the rate of adverse maternal or neonatal outcomes or maternal satisfaction between the nifedipine and terbutaline groups, and women in both groups showed a similar preference for oral administration (62% nifedipine and 71% terbutaline)."

The authors concluded: "This review found no evidence to support the use of nifedipine for tocolysis to facilitate external cephalic version."

This question seems settled.


For the full abstract, click here.

BJOG 118(4):423-428, March 2011 © 2010 to the Royal College of Obstetricians and Gynaecologists
Effectiveness of nifedipine tocolysis to facilitate external cephalic version: a systematic review. CB Wilcox, N Nassar, CL Roberts.

Category: W. Pregnancy, Childbirth, Family Planning. Keywords: breech presentation, external cephalic version, nifedipine, tocolysis, meta-analysis of randomized controlled trials, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 8 March 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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