Cesarean delivery after successful external cephalic version of breech presentation at term: a comparative study

Area of Science:

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

Background:

• External cephalic version (ECV) is a procedure to externally manipulate a fetus from a breech to a cephalic presentation.
• Successful ECV aims to reduce the rate of cesarean delivery for breech presentation.
• The impact of successful ECV on subsequent delivery mode and indications requires further investigation.

Purpose of the Study:

• To evaluate the rate and indications for cesarean delivery following a successful external cephalic version.
• To compare cesarean delivery rates between women who underwent successful ECV and a control group.

Main Methods:

• A case-control study comparing 602 women who underwent successful ECV with matched controls.
• Separate analysis for nulliparous and multiparous women.
• Statistical analysis included Chi-squared, Mann-Whitney, Student t tests, and multivariate logistic regression.

Main Results:

• Cesarean delivery rates were significantly higher after successful ECV in both nulliparous (29.8% vs 15.9%) and multiparous women (15.9% vs 4.7%).
• Successful ECV was associated with increased cesarean delivery for dystocia in both groups.
• Multivariate analysis confirmed successful ECV increased the odds of cesarean delivery at term (nulliparous OR 2.04, multiparous OR 4.30).

Conclusions:

• Successful external cephalic version is associated with an increased rate of cesarean delivery, primarily due to dystocia.
• This association holds true for both nulliparous and multiparous women.
• Clinicians should consider these findings when counseling patients regarding ECV.