Epidural analgesia coupled with tocolysis has been reported to increase version success rates compared with tocolysis alone (Goetzinger, 2011; Magro-Malosso, 2016). Moreover, rates of complications that include fetal heart rate aberrations, emergency cesarean delivery, or placental abruption were not greater with regional analgesia. Of randomized trials, spinal and epidural have both shown success (Khaw, 2015; Weiniger, 2010). Currently, the superior technique and best drugs to administer are unclear. In contrast, from limited data, intravenous sedation does not appear to improve success rates (Burgos, 2016; Khaw, 2015).
This is a traditional Chinese medicine technique that burns a cigarette-shaped stick of ground Artemisia vugaris-which is also known as mugwort or in Japanese as moxa. At the BL 67 acupuncture point, the stick is directly placed against the skin or indirectly heats an acupuncture needle at the site to increase fetal movement and promote spontaneous breech version (Ewies, 2002). It is performed usually between 33 and 36 weeks' gestation to permit a trial of ECV if not successful. Results from randomized controlled studies are conflicting (Bue, 2016; Coulon, 2014; Coyle, 2012; Sananes, 2016; Vas, 2013).
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