[External cephalic version as a possible treatment of breech presentation]

Area of Science:

• Obstetrics and Gynecology
• Perinatal Medicine
• Fetal Medicine

Background:

• Breech presentation occurs in 3-4% of deliveries and is associated with increased risks of perinatal mortality, malformations, low birth weight, and prematurity.
• Unassisted breech delivery carries higher risks of perinatal morbidity and mortality compared to cephalic presentation.
• Cesarean section, while reducing some risks, also carries maternal morbidity and a small perinatal mortality risk.

Purpose of the Study:

• To evaluate the efficacy of external cephalic version (ECV) in reducing the incidence of breech presentation at delivery.
• To assess the success rate of ECV and its impact on delivery mode.
• To identify factors influencing ECV success.

Main Methods:

• A study group of 67 patients with breech presentation at 35.8 +/- 1.9 weeks gestation underwent ECV.
• The forward roll technique was used by a single physician, with tocolysis administered in 50 cases.
• Variables analyzed included amniotic fluid amount, gestational age, tocolysis type, placental location, fetal back position, parity, breech variety, and complications.

Main Results:

• ECV was successful in 77.6% of cases, with 74.6% resulting in vaginal delivery.
• No maternal or fetal complications were reported.
• Successful ECV was significantly associated with amniotic fluid volume, tocolysis type, and umbilical cord rounds; unsuccessful ECV was linked to higher gestational age.

Conclusions:

• External cephalic version (ECV) is an effective therapeutic approach for reducing breech presentation at delivery.
• ECV increases the likelihood of physiological vaginal deliveries.
• The study highlights the importance of factors like amniotic fluid and tocolysis in ECV success.