Establishing an external cephalic version clinic: outcome of the first year

The effect of introducing an external cephalic version (ECV) clinic was evaluated after 12 months. The practical procedure of establishing the clinic, its protocol and the technique of ECV is described. All women had singleton pregnancies of at least 36 weeks gestation. There were 61 'primary' attempts at ECV, and one repeat attempt. The operator performing the majority of the ECVs had a 56% success rate, whilst the overall rate for the clinic was 53%. There was minimal fetal and maternal morbidity. Success according to placental site, parity, gestation and type of breech as well as the mode of delivery and neonatal outcome of all patients on whom ECV was attempted is presented. There was a significant decrease in the total number of breech deliveries, mainly through a 60% reduction in emergency caesarean section. The cost effectiveness of the clinic and the use of tocolytics is discussed.