A prospective audit of external cephalic version at term: are ultrasound parameters predictive of outcome?

This prospective study was designed to audit our provision of external cephalic version (ECV) but also to assess the relative importance of various ultrasound markers as indicators of a successful outcome. Data were collected between November 1998 and November 1999. There were 102 breech presentations at term and 47 women had an external cephalic version. We had an overall success rate of 55% with no adverse outcomes. Parity, a non-extended breech presentation and posterior placenta were all independently associated with a higher success rate. As only 49% of women with an uncomplicated breech presentation at term agreed to have an ECV the audit has prompted us to assess how we might improve the uptake of our service. Given that fetal position and placental site seem to influence outcome, we would suggest that a basic ultrasound scan should form part of the procedure. The audit has confirmed the value of ECV in reducing the incidence of breech presentation at term. With the increasing caesarean section rate for this obstetric problem it is important that all units in the United Kingdom are able to provide this service.