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Cephalic version by postural management for breech presentation
1Effective Care Research Unit, University of the Witwatersrand, Frere/Cecilia Makiwane Hospitals, Private Bag 9047, East London 5200, Eastern Cape, South Africa. gjh@global.co.za.
Background:
It is possible that maternal posture may influence fetal position. Many postural techniques have been used to promote cephalic version.
Objectives:
The objective of this review was to assess the effects of postural management of breech presentation on measures of pregnancy outcome.
Search Strategy:
The Cochrane Pregnancy and Childbirth trials register and Controlled Trials Register were searched. Date of last search: March 2000.
Selection Criteria:
Randomised and quasi-randomised trials comparing postural management with pelvic elevation for breech presentation, with a control group.
Data Collection And Analysis:
Eligibility and trial quality were assessed by one or both reviewers.
Main Results:
Five studies involving a total of 392 women were included. No effect of postural management on the rate non-cephalic births was detected, either for the subgroup in which no external cephalic version was attempted, or for the group overall (relative risk 0.95, 95% confidence interval 0.81 to 1.11). No differences were detected for caesarean sections or Apgar scores below seven at one minute.
Reviewer'S Conclusions:
There is no evidence to support the use of postural management for breech presentation. The numbers of women studied to date remain relatively small.