Comparing spinal anaesthesia and epidural anaesthesia in cephalic external version: a protocol for systematic review and network meta-analysis.

INTRODUCTION

Breech presentation, occurring in approximately 3-5% of term pregnancies, is associated with increased risks of complications during vaginal delivery, including challenges in delivering the aftercoming head, umbilical cord prolapse, birth trauma and neonatal asphyxia. External cephalic version (ECV) is a recommended procedure to reposition the fetus from a non-cephalic to a cephalic presentation, aiming to reduce the risks associated with breech presentation and increase the likelihood of a vaginal delivery. We aimed to determine the impact of neuraxial analgesia on the success rate and safety of ECV by conducting a systematic review and network meta-analysis.

METHODS AND ANALYSIS

A comprehensive search will be conducted in electronic databases such as Cochrane Central Register of Controlled Trials (The Cochrane Library), PubMed, Web of Science and Embase. Studies investigating the effects of neuraxial analgesia, including spinal and epidural analgesia, on ECV success rates and patient safety will be included. The primary outcome is the success rate of ECV, while secondary outcomes include adverse events, complications and maternal and fetal well-being.

ETHICS AND DISSEMINATION

Ethical approval is not required as this review will analyse existing literature without patient involvement. The findings, which aim to assess the effects of neuraxial analgesia in ECV procedures, are expected to inform clinical practice and improve patient care. The results will be disseminated through publication in a peer-reviewed journal and presentation at relevant conferences.

PROSPERO REGISTRATION NUMBER

CRD42023047525.