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Cephalic version by postural management for breech presentation.

G J Hofmeyr1, R Kulier

  • 1Department of Obstetrics and Gynaecology, Coronation Hospital and University of the Witwatersrand, 7 York Road, Parktown 2193, Johannesburg, South Africa. 091just@chiron.wits.ac.za

The Cochrane Database of Systematic Reviews
|May 5, 2000
PubMed
Summary

Maternal posture may influence fetal position. This review found insufficient evidence to support postural management for breech presentation, with no significant impact on birth outcomes.

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Evidence-Based Midwifery

Background:

  • Maternal posture is hypothesized to affect fetal positioning.
  • Various postural techniques are employed to encourage cephalic version (head-first presentation).

Purpose of the Study:

  • To systematically review the impact of postural management on pregnancy outcomes for breech presentations.
  • To assess the efficacy of specific postural interventions in altering fetal lie.

Main Methods:

  • Searched the Cochrane Pregnancy and Childbirth trials register and Controlled Trials Register (up to February 1999).
  • Included randomized and quasi-randomized trials comparing postural management with pelvic elevation for breech presentation against a control group.
  • Assessed eligibility and trial quality by two independent reviewers.

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Main Results:

  • Three studies with 192 women were analyzed.
  • Postural management showed a non-significant trend towards fewer non-cephalic births (RR 0.90; 95% CI 0.73-1.12).
  • No significant differences were observed in rates of cesarean sections or low Apgar scores.

Conclusions:

  • Current evidence is insufficient to determine the effectiveness of postural management for breech presentation.
  • Further high-quality research is needed to evaluate this intervention.