Maternal experience of pain during external cephalic version at term

Background This study was designed to investigate maternal pain perception during external cephalic version (ECV). Methods This prospective study included 97 pregnant women with singleton breech presentation at or above 36 weeks of gestation undergoing ECV. No analgesia or anesthesia were used during ECV. The women were asked to rate the degree of pain on a 10-cm visual analog scale after ECV. Results Ninety-eight ECVs were performed and the overall success rate was 66%. The median pain score was 5.7 (interquartile range 2.7-6.8). The visual analog pain score was significantly lower among those with a successful ECV than those with a failed procedure (median score 4.6 vs. 6.8, p < 0.001). Similarly, those procedures rated as easy by the operator were associated with a significantly lower pain score (3.4 vs. 6.4, p < 0.001). However, the pain score was not found to be related to the operator, parity or placental site. Among the five subjects with a pain score of 8.5 and beyond, the ECV procedure was still successful in four (80%). Conclusion ECV performed without analgesia was associated with a moderate degree of pain that was well tolerated by the majority of patients because of its short duration.