Nifedipine versus terbutaline for tocolysis in external cephalic version

Objective: To study the efficacy of nifedipine compared with terbutaline as a tocolytic agent in external cephalic version (ECV).

Methods: A prospective, randomized, comparative trial was carried out in a tertiary hospital. Women with singleton term breech pregnancies were randomized for nifedipine (group A) and terbutaline (group B) tocolysis for ECV in an outpatient setting. The efficacy, side effects, and complications were analyzed and compared.

Results: A total of 86 women were recruited with 43 women in each group. The overall success rate was 48.8% and this reduced the rate of cesarean delivery for breech presentation by 32.5% in our center. ECV was successful in 39.5% of women in group A and 58.1% in group B. Fewer side effects were experienced by the women in group A compared with group B, although this was not significant.

Conclusion: Nifedipine can be used as an alternative for tocolysis in ECV when there are maternal contraindications to beta-sympathomimetics.