Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia
Effectiveness and safety of adjunct interventions for external cephalic version in breech presentation: a systematic review and meta-analysis
By Bortoli AC and Fortunato VCR.
Abstract
Objective
To evaluate the efficacy and safety of adjunct and implementation-related strategies associated with external cephalic version (ECV) in pregnant women with breech presentation.
Methods
Randomized controlled trials comparing adjunct or protocol-based strategies related to ECV (including pharmacological tocolysis, neuraxial anesthesia or analgesia, systemic analgesia, or timing/procedural approaches) with standard care, placebo, or expectant management were included. Search strategy: MEDLINE (PubMed), Embase, Scopus, Cochrane CENTRAL, and LILACS were searched from inception to February 2026. Data selection and extraction: Data extraction and risk of bias assessment using the Cochrane RoB 2 tool were performed independently by two reviewers. Dichotomous outcomes were pooled using risk ratios (RR) with 95% confidence intervals (CI) under random-effects models.