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External Cephalic Version: Is it an Effective and Safe Procedure?
Published on: June 6, 2020
The incidence of spontaneous version after failed external cephalic version
Assaf Ben-Meir1, Tamar Elram, Avi Tsafrir
1Department of Obstetrics and Gynecology, Hadassah Hebrew University Medical Center, Ein-Kerem, Jerusalem, Israel.
American Journal of Obstetrics and Gynecology
|February 20, 2007
Summary
The rate of spontaneous version after failed external cephalic version (ECV) is low, particularly in nulliparous women. This suggests careful consideration of delivery plans following unsuccessful ECV attempts is necessary.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
Background:
- External cephalic version (ECV) is a procedure to turn a fetus from a breech to a vertex presentation.
- Failed ECV leaves the fetus in a non-vertex presentation, necessitating alternative delivery management.
Purpose of the Study:
- To determine the incidence of spontaneous version to vertex presentation after a failed ECV attempt at term.
- To evaluate factors influencing spontaneous version post-ECV failure.
Main Methods:
- Prospective data collection of ECV trials from January 1997 to June 2005.
- Inclusion of demographic and obstetric parameters for analysis.
- Follow-up of patients with failed ECV to ascertain spontaneous version before labor onset.
Main Results:
- A total of 603 ECV attempts were analyzed.
- Success rates for ECV were 72.3% in multiparas and 46.1% in nulliparas.
- Among 226 failed ECV attempts, spontaneous version occurred in 6.6% (15 of 226), with a higher rate in multiparas (12.5%) compared to nulliparas (2.3%).
Conclusions:
- The incidence of spontaneous version after failed ECV is low, especially in nulliparous women.
- ECV should be performed in facilities prepared for immediate cesarean delivery if vaginal breech delivery is not an option.
- Consideration of performing ECV after 39 weeks may reduce neonatal respiratory morbidity.
