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Related Experiment Videos

How useful is external cephalic version in clinical practice?

M Higgins1, M J Turner

  • 1Coombe Women's Hospital, Dolphins Barn, Dublin, Ireland.

Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology
|November 30, 2006
PubMed
Summary
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External cephalic version (ECV) success rates were low in our hospital, preventing few C-sections. This suggests a need to review current ECV practices for breech presentations.

Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine

Background:

  • Singleton breech presentation occurs in a significant percentage of late-term pregnancies.
  • External cephalic version (ECV) is a recommended procedure to convert breech to cephalic presentation.
  • Guidelines from the Royal College of Obstetricians and Gynaecologists (RCOG) recommend ECV.

Purpose of the Study:

  • To audit the success rate and impact of external cephalic version (ECV) for singleton breech presentations.
  • To evaluate the effectiveness of ECV in reducing cesarean section rates in a hospital setting.

Main Methods:

  • Retrospective review of all women with singleton breech presentation after 36 weeks' gestation referred for ECV.
  • Data collected over a 3-year period (2001-2003).
  • Analysis of ECV success rates and the number of cesarean sections prevented.

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Main Results:

  • A low number of women (n=107) were referred for ECV over the 3-year period.
  • The overall ECV success rate was low at 24.5%.
  • ECV prevented only 15 cesarean sections, making a minimal contribution to reducing the hospital's cesarean section rate.

Conclusions:

  • The low success rate of ECV in this hospital audit suggests a need for review of current practices.
  • There is a discrepancy between reported ECV success rates by enthusiasts and outcomes in routine obstetric practice.
  • Further investigation into improving ECV efficacy in clinical settings is warranted.