Nifedipine not helpful in breech correction procedure

Nifedipine, a calcium antagonist with relaxant effects on the myometrium, didn't significantly improve the success of external cephalic version in women with a fetus in breech presentation, according to research published in the August issue of Obstetrics and Gynecology.

Marjolein Kok, MD, of the Academic Medical Centre in Amsterdam, the Netherlands, and colleagues analyzed data from 310 women with a breech presentation singleton fetus at a gestational age of 36 weeks or later. The women were randomized to receive nifedipine or placebo before the attempted external cephalic version. Women in the treatment group received 10 mg of the drug 30 and 15 minutes before the procedure.

The researchers found no significant difference in success rates for the procedure between the groups and no significant difference in the rates of cesarean delivery in the women.

“Cephalic presentation after external cephalic version in our study was not different from the success rates of the placebo groups described in other studies ranging from 28% to 68%. Therefore, we feel confident that the external cephalic version was carried out properly. In addition, the cesarean delivery rate for breech presentation in this trial was 68%. After external cephalic version in 310 women, 120 delivered vaginally in cephalic position. Thus, our study confirms the benefits of external cephalic version in the reduction of maternal and neonatal complications,” the authors write.

Kok M, Bais JM, van Lith JM, et al. Nifedipine as a uterine relaxant for external cephalic version. A randomized controlled trial. Obstet Gynecol. 2008;112:271-276