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External cephalic version: predictors of success.

G A Aisenbrey1, V A Catanzarite, C Nelson

  • 1University of New Mexico Hospital, Albuquerque, USA.

Obstetrics and Gynecology
|November 5, 1999
PubMed
Summary

External cephalic version (ECV) success rates are influenced by several factors. Low uterine tone is a strong predictor of successful ECV, with other variables also contributing to successful breech to vertex conversion.

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Area of Science:

  • Obstetrics
  • Maternal-Fetal Medicine
  • Perinatology

Background:

  • Breech presentation occurs in 3-5% of term pregnancies.
  • External cephalic version (ECV) is a procedure to manually turn a fetus from breech to vertex presentation.
  • Successful ECV can reduce the rate of cesarean deliveries.

Purpose of the Study:

  • To identify predictive variables for successful external cephalic version (ECV).
  • To determine which factors influence the success rate of ECV procedures.

Main Methods:

  • A retrospective analysis of 128 external cephalic version attempts between 1987 and 1996.
  • Evaluation of multiple potential predictors including uterine tone, fetal spine position, breech location, breech type, gestational age, placental location, parity, maternal weight, amniotic fluid index, and estimated fetal weight.

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Main Results:

  • External cephalic version was successful in 64% (78/128) of cases.
  • Low uterine tone was associated with a 100% success rate.
  • In cases of high uterine tone, success was predicted by anterior/lateral fetal spine position, noncornual placental location, and breech location out of the pelvis.
  • Additional successful predictors included non-frank breech presentation, gestational age < 38 weeks, and parity ≥ 1.

Conclusions:

  • Uterine tone appears to be a critical factor in selecting candidates for external cephalic version.
  • A combination of factors can predict success in external cephalic version when uterine tone is high.