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Related Experiment Videos

External cephalic version for breech presentation at term.

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

External cephalic version at term significantly reduces non-cephalic births and cesarean sections. However, current evidence is insufficient to determine potential risks associated with this procedure.

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Perinatal Care

Background:

  • Management of breech presentation remains controversial, encompassing fetal manipulation and delivery methods.
  • External cephalic version (ECV) may decrease breech presentations and cesarean births, but concerns exist regarding perinatal mortality.

Purpose of the Study:

  • To evaluate the impact of external cephalic version performed at term on various pregnancy outcomes.

Main Methods:

  • A systematic review of randomized controlled trials was conducted using the Cochrane Pregnancy and Childbirth trials register (searched October 1997).
  • Included were trials comparing ECV at term (with or without tocolysis) against no attempt at ECV in women with breech presentation.
  • Trial eligibility and quality were assessed by two independent reviewers.

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Main Results:

  • Six studies were included in the analysis.
  • External cephalic version at term demonstrated a significant reduction in non-cephalic births (RR 0.42, 95% CI 0.35-0.50) and cesarean sections (RR 0.52, 95% CI 0.39-0.71).
  • No statistically significant effect on perinatal mortality was observed (RR 0.44, 95% CI 0.07-2.92).

Conclusions:

  • Performing external cephalic version at term appears to lower the incidence of non-cephalic births and cesarean deliveries.
  • Insufficient evidence currently exists to definitively assess the potential risks of ECV at term.