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External cephalic version: a safe procedure? A systematic review of version-related risks.
Ronald J Collaris1, S Guid Oei
1Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, the Netherlands.
Acta Obstetricia Et Gynecologica Scandinavica
|May 18, 2004
Summary
External cephalic version (ECV) is a safe procedure for turning breech babies, potentially reducing cesarean rates. This systematic review confirms low complication risks, supporting its use in obstetrics.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Perinatal Research
Background:
- The Term Breech Trial led to increased cesarean rates.
- External cephalic version (ECV) is a potential method to reduce cesarean deliveries.
- Previous studies on ECV risks were limited by small sample sizes.
Purpose of the Study:
- To systematically analyze the risks associated with external cephalic version.
- To provide a comprehensive overview of ECV-related complications.
- To evaluate the safety of ECV in a large patient cohort.
Main Methods:
- Systematic analysis of 44 studies published between 1990 and 2002.
- Inclusion of 7377 patients undergoing external cephalic version.
- Data sourced from Medline and Embase searches.
Main Results:
- Transient abnormal cardiotocography (CTG) patterns occurred in 5.7% of cases.
- Rare complications included persisting pathological CTG (0.37%), vaginal bleeding (0.47%), and placental abruption (0.12%).
- Emergency cesareans were performed in 0.43%, with a perinatal mortality of 0.16%.
Conclusions:
- External cephalic version (ECV) demonstrates a favorable safety profile.
- The procedure appears effective in managing breech presentations.
- Low incidence of serious complications supports the routine use of ECV.