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[External cephalic version: experience about 237 versions at Port-Royal maternity].
T Le Bret1, G Grangé, F Goffinet
1Maternité Port Royal, CHU Cochin-Port-Royal, 127, boulevard Port-Royal, 75014 Paris. tlebret@hopital-dcss.org
Summary
External cephalic version (ECV) is a safe procedure that can reduce cesarean section rates in breech presentations. This method offers a higher chance of vaginal birth while ensuring fetal well-being.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
Context:
- Breech presentation complicates approximately 3-5% of term deliveries.
- Cesarean delivery is often recommended for breech presentation, increasing maternal morbidity.
- External cephalic version (ECV) aims to convert a breech presentation to a cephalic one before labor.
Purpose:
- To assess the efficacy of external cephalic version (ECV) in reducing cesarean section rates.
- To evaluate the safety of ECV by monitoring fetal well-being.
- To determine factors associated with successful ECV.
Summary:
- A retrospective review of 237 ECV procedures was conducted.
- The success rate for ECV was 50.6%, with a cesarean section rate of 12.5% in the success group and 53% in the unsuccessful group.
- Successful ECV was linked to multiparity, complete breech presentation, and adequate amniotic fluid volume.
Impact:
- ECV reduced the cesarean section rate by approximately 20.5% in breech presentations.
- The procedure was associated with low rates of abnormal fetal heart rate tracings (3.4%) and no major complications.
- ECV can lower maternal morbidity and should be considered when safety criteria and fetal monitoring are maintained.