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TerminatedNCT00465712AMNIOUpdated Dec 30, 2025

Effect of Amnioinfusion on External Cephalic Version Successful Rate

An interventional study of transabdominal amnioinfusion in Breech Presentation, sponsored by University Hospital, Tours. Terminated at 2 sites in France. Open to female participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-12-30.

Sponsored by University Hospital, Tours · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
119
Allocation
Randomized
Ages
18 Years and older
Sex
Female
01

Study summary

The aim of the study is to evaluate the effect of transabdominal amnioinfusion before second external cephalic version after initial failure.Patient with a single foetus, at term, in breech presentation and after a first cephalic version are included. The randomisation determines whether the patient is included in the group with amnioinfusion before second cephalic version or with usual second cephalic version only; The efficacy's evaluation is based on rate of cephalic presentation at birth.Success rate of cephalic version with or without transabdominal amnioinfusion, rates of cesarian section in the two groups,maternal and fetal morbidity, time between second cephalic version and birth will be studied.

Prospective interventional randomized sequential comparative multicentric study. A maximum of 240 patients will be included (120 in each group). As the study is sequential it will be over as soon as a significative difference is shown.

Read the detailed description

The purpose of the study is to evaluate the effect of transabdominal amnioinfusion before a second external cephalic version after initial failure. In case of success it could be an alternative to cesarian section. Without any other technique the foetus is in cephalic presentation after a first external cephalic version in 50%.

Patients with a single fetus, at term, in breech presentation are proposed to participate. The randomization is done at the inclusion and determines whether the patient is included in the group with amnioinfusion before second cephalic version or usual second cephalic version only. The only difference between the two groups is the realisation of an amnioinfusion, the cephalic version's technique is the same.

Efficacy's evaluation is based on rate of cephalic presentation at birth. Success rate of cephalic version, rates of cesarian section, maternal and fetal morbidity in the two groups, time between second cephalic version and birth will be studied.

02

Conditions studied

  • Breech Presentation

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Keywords

  • transabdominal amnioinfusion
  • external cephalic version
  • breech presentation
03

In context

Breech Presentation

41 studies on the registry are indexed under Breech Presentation; 10 are open to participants now.

This study's enrollment of 119 is close to the median of 119 across 31 interventional studies indexed under Breech Presentation.

Browse Breech Presentation studies →

Lead sponsor

University Hospital, Tours is the lead sponsor of 307 studies on the registry; 79 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
Female
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • single fetal pregnancy
  • breech presentation
  • at term
  • initial failure of external cephalic version
  • structurally normal foetus

Exclusion criteria

Exclusion Criteria:

  • polyhydramnios
  • anhydramnios
  • abnormality of the fetal heart rhythm
  • uterine congenital malformation
  • cesarian section for a previous birth
  • unability to understand study
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
119 participants (actual)

Study arms

  • Experimental
    A

    Transabdominal amnioinfusion performed before external cephalic version

    Procedure: transabdominal amnioinfusion

  • No intervention
    V

    Without transabdominal amnioinfusion

Interventions

  • Proceduretransabdominal amnioinfusion

    transabdominal amnioinfusion performed 4 to 24 hours before the second trial of external cephalic version

06

What researchers measure

Primary outcomes

  1. cephalic presentation at birth

    Time frame: at birth

07

Study locations

2 sites
  • Mother Child University Hospital
    Nantes, 44000, France
  • Olympe de Gouges Women Health Centre, Bretonneau University Hospital
    Tours, 37000, France
08

References and documents

Publications

  • Benifla JL, Goffinet F, Darai E, Madelenat P. Antepartum transabdominal amnioinfusion to facilitate external cephalic version after initial failure. Obstet Gynecol. 1994 Dec;84(6):1041-2. PubMed 7970462 ↗
  • Benifla JL, Goffinet F, Bascou V, Darai E, Proust A, Madelenat P. [Transabdominal amnio-infusion facilitates external version maneuver after initial failure. Six successful attempts]. J Gynecol Obstet Biol Reprod (Paris). 1995;24(3):319-22. French. PubMed 7622781 ↗
  • Boucher M, Bujold E, Marquette GP, Vezina Y. The relationship between amniotic fluid index and successful external cephalic version: a 14-year experience. Am J Obstet Gynecol. 2003 Sep;189(3):751-4. doi: 10.1067/s0002-9378(03)00846-9. PubMed 14526307 ↗
  • Cheng M, Hannah M. Breech delivery at term: a critical review of the literature. Obstet Gynecol. 1993 Oct;82(4 Pt 1):605-18. PubMed 8377990 ↗
  • Collaris RJ, Oei SG. External cephalic version: a safe procedure? A systematic review of version-related risks. Acta Obstet Gynecol Scand. 2004 Jun;83(6):511-8. doi: 10.1111/j.0001-6349.2004.00347.x. PubMed 15144330 ↗
  • Collea JV, Chein C, Quilligan EJ. The randomized management of term frank breech presentation: a study of 208 cases. Am J Obstet Gynecol. 1980 May 15;137(2):235-44. doi: 10.1016/0002-9378(80)90780-2. PubMed 7377243 ↗
  • Fernandez CO, Bloom SL, Smulian JC, Ananth CV, Wendel GD Jr. A randomized placebo-controlled evaluation of terbutaline for external cephalic version. Obstet Gynecol. 1997 Nov;90(5):775-9. doi: 10.1016/S0029-7844(97)00440-7. PubMed 9351763 ↗
  • Fischer R. Breech Presentation. 2004. http://www.emedicine.com/med/topic3272.htm
  • Fisk NM, Ronderos-Dumit D, Soliani A, Nicolini U, Vaughan J, Rodeck CH. Diagnostic and therapeutic transabdominal amnioinfusion in oligohydramnios. Obstet Gynecol. 1991 Aug;78(2):270-8. PubMed 2067774 ↗
  • Flamm BL, Fried MW, Lonky NM, Giles WS. External cephalic version after previous cesarean section. Am J Obstet Gynecol. 1991 Aug;165(2):370-2. doi: 10.1016/0002-9378(91)90095-9. PubMed 1872341 ↗
  • Gembruch U, Hansmann M. Artificial instillation of amniotic fluid as a new technique for the diagnostic evaluation of cases of oligohydramnios. Prenat Diagn. 1988 Jan;8(1):33-45. doi: 10.1002/pd.1970080105. PubMed 3278306 ↗
  • Gimovsky ML, Wallace RL, Schifrin BS, Paul RH. Randomized management of the nonfrank breech presentation at term: a preliminary report. Am J Obstet Gynecol. 1983 May 1;146(1):34-40. doi: 10.1016/0002-9378(83)90923-7. PubMed 6342396 ↗
  • Gramellini D, Fieni S, Kaihura C, Faiola S, Vadora E. Transabdominal antepartum amnioinfusion. Int J Gynaecol Obstet. 2003 Nov;83(2):171-8. doi: 10.1016/s0020-7292(03)00274-1. PubMed 14550592 ↗
  • Gramellini D, Fieni S, Kaihura C, Piantelli G, Verrotti C. Antepartum amnioinfusion: a review. J Matern Fetal Neonatal Med. 2003 Nov;14(5):291-6. doi: 10.1080/jmf.14.5.291.296. PubMed 14986801 ↗
  • Gramellini D, Fieni S, Piantelli G, Faiola S, Kaihura C, Verrotti C, Cavallotti D, Viola P, Bacchini G, Vadora E. [Amnioinfusion: techniques, indications, and controlled retrospective study of 55 cases]. Acta Biomed Ateneo Parmense. 2000;71 Suppl 1:325-9. Italian. PubMed 11424764 ↗
  • Hannah ME, Hannah WJ, Hewson SA, Hodnett ED, Saigal S, Willan AR. Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial. Term Breech Trial Collaborative Group. Lancet. 2000 Oct 21;356(9239):1375-83. doi: 10.1016/s0140-6736(00)02840-3. PubMed 11052579 ↗
  • Hellstrom AC, Nilsson B, Stange L, Nylund L. When does external cephalic version succeed? Acta Obstet Gynecol Scand. 1990;69(4):281-5. doi: 10.3109/00016349009036147. PubMed 2244457 ↗
  • Hofmeyr GJ, Gyte G. Interventions to help external cephalic version for breech presentation at term (Cochrane Review). In: The Cochrane Library, Issue 3, 2004a. Chichester, UK: John Wiley & Sons, Ltd.
  • Hofmeyr GJ, Hannah ME. Planned caesarean section for term breech delivery (Cochrane Review). In: The Cochrane Library, Issue 3, 2004b. Chichester, UK: John Wiley & Sons, Ltd
  • Hofmeyr GJ, Kulier R. Cephalic version by postural management for breech presentation. Cochrane Database Syst Rev. 2000;(3):CD000051. doi: 10.1002/14651858.CD000051. PubMed 10908458 ↗
  • Hofmeyr GJ, Kulier R. External cephalic version for breech presentation at term (Cochrane Review). In: The Cochrane Library, Issue 3, 2004d. Chichester, UK: John Wiley & Sons, Ltd
  • Hofmeyr GJ. External cephalic version facilitation for breech presentation at term. Cochrane Database Syst Rev. 2000;(2):CD000184. doi: 10.1002/14651858.CD000184. PubMed 10796176 ↗
  • Hofmeyr GJ. External cephalic version for breech presentation before term (Cochrane Review). In: The Cochrane Library, Issue 3, 2004e. Chichester, UK: John Wiley & Sons, Ltd.
  • Hutton EK, Kaufman K, Hodnett E, Amankwah K, Hewson SA, McKay D, Szalai JP, Hannah ME. External cephalic version beginning at 34 weeks' gestation versus 37 weeks' gestation: a randomized multicenter trial. Am J Obstet Gynecol. 2003 Jul;189(1):245-54. doi: 10.1067/mob.2003.442. PubMed 12861170 ↗
  • Kotaska A. Inappropriate use of randomised trials to evaluate complex phenomena: case study of vaginal breech delivery. BMJ. 2004 Oct 30;329(7473):1039-42. doi: 10.1136/bmj.329.7473.1039. PubMed 15514356 ↗
  • Lansac J, Body G, Perrotin F, Marret H. Pratique de l'accouchement. Paris: Masson ; 2001, p. 365-369.
  • Le Bret T, Grange G, Goffinet F, Cabrol D. [External cephalic version: experience about 237 versions at Port-Royal maternity]. J Gynecol Obstet Biol Reprod (Paris). 2004 Jun;33(4):297-303. doi: 10.1016/s0368-2315(04)96458-7. French. PubMed 15170425 ↗
  • Lilford RJ, van Coeverden de Groot HA, Moore PJ, Bingham P. The relative risks of caesarean section (intrapartum and elective) and vaginal delivery: a detailed analysis to exclude the effects of medical disorders and other acute pre-existing physiological disturbances. Br J Obstet Gynaecol. 1990 Oct;97(10):883-92. doi: 10.1111/j.1471-0528.1990.tb02442.x. PubMed 2223678 ↗
  • Newman RB, Peacock BS, VanDorsten JP, Hunt HH. Predicting success of external cephalic version. Am J Obstet Gynecol. 1993 Aug;169(2 Pt 1):245-9; discussion 249-50. doi: 10.1016/0002-9378(93)90071-p. PubMed 8362933 ↗
  • Novakov-Mikic A, Stojic S, Bogavac M, Mandic A. [Amnionic infusion therapy in conditions with low amnionic fluid levels]. Med Pregl. 2003 Jan-Feb;56(1-2):33-7. doi: 10.2298/mpns0302033n. Croatian. PubMed 12793184 ↗
  • Perrotin F, Sauget S, Laffont M, Lansac J, Body G. Version par manœuvre externe: nouveaux apports techniques. In: Collège National des Gynécologues Obstétriciens Français. Mises à jour en Gynécologie Obstétrique - VIGOT Ed. - Paris, 2003;25:5-23
  • Pritchard JA, MacDonald PC. Dystocia caused by abnormalities in presentation, position, or development of the fetus. Williams Obstetrics. Norwalk, CT: Appleton-Century-Crofts; 1980, p. 787-796.
  • Rietberg CC, Elferink-Stinkens PM, Brand R, van Loon AJ, Van Hemel OJ, Visser GH. Term breech presentation in The Netherlands from 1995 to 1999: mortality and morbidity in relation to the mode of delivery of 33824 infants. BJOG. 2003 Jun;110(6):604-9. PubMed 12798480 ↗
  • Royal College of Obstetricians and Gynaecologists Clinical Audit Unit. Effective procedures in maternity care suitable for audit. London: RCOG Press; 1997;4(7). Breech presentation at term, p. 32.
  • Royal College of Obstetricians and Gynaecologists The management of breech presentation. 2001
  • Royal College of Obstetricians and Gynaecologists. Use of anti-D immunoglobulin for Rh Prophylaxis. London: RCOG Press; 1999. Guideline n° 22
  • Shalev E, Battino S, Giladi Y, Edelstein S. External cephalic version at term--using tocolysis. Acta Obstet Gynecol Scand. 1993 Aug;72(6):455-7. doi: 10.3109/00016349309021134. PubMed 8394624 ↗
  • Stuart IP. Term breech trial. Lancet. 2001 Jan 20;357(9251):228. doi: 10.1016/S0140-6736(05)71325-8. No abstract available. PubMed 11213120 ↗
  • Wagner A, Potin J, Himily V, Arbeille P, Perrotin F. The "Loss Of Resistance" Syringe: a useful tool for difficult amnioinfusion. Fetal Diagn Ther (submitted).
  • Mousa HA. Re: Ledee et al. Management in intractable obstetric haemorrhage: an audit study on 61 cases. Eur J Obstet Gynecol Reprod Biol 2001;94:189-96. Eur J Obstet Gynecol Reprod Biol. 2001 Dec 10;100(1):116-7. doi: 10.1016/s0301-2115(01)00438-9. No abstract available. PubMed 11728673 ↗
  • Zhang J, Bowes WA Jr, Fortney JA. Efficacy of external cephalic version: a review. Obstet Gynecol. 1993 Aug;82(2):306-12. PubMed 8336883 ↗
  • Diguisto C, Winer N, Descriaud C, Tavernier E, Weymuller V, Giraudeau B, Perrotin F. Amnioinfusion for women with a singleton breech presentation and a previous failed external cephalic version: a randomized controlled trial. J Matern Fetal Neonatal Med. 2018 Apr;31(8):993-999. doi: 10.1080/14767058.2017.1304909. Epub 2017 Mar 28. PubMed 28279119 ↗
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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Dec 30, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT00465712
Responsible party
Sponsor
First posted
Apr 25, 2007
Start date
Jul 2006
Primary completion
May 2011
Completion
May 2011
Last update
Dec 30, 2025

Study contacts

Franck Perrotin, MD-PhD
principal investigator · Tours University Hospital

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

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This study is terminated, as verified in Dec 2025. You cannot join it, but the record below documents what was studied.

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