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Updated: Jun 28, 2026

External Cephalic Version: Is it an Effective and Safe Procedure?

External Cephalic Version: Is it an Effective and Safe Procedure?

Published on: June 6, 2020

External cephalic version-related risks: a meta-analysis.

Kim Grootscholten¹, Marjolein Kok, S Guid Oei

¹Department of Obstetrics and Gynecology, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands.

Obstetrics and Gynecology

|November 4, 2008

Summary

This summary is machine-generated.

External cephalic version (ECV) is a safe procedure for breech pregnancies. Complications are uncommon and not linked to the success of the version attempt.

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Last Updated: Jun 28, 2026

External Cephalic Version: Is it an Effective and Safe Procedure?

External Cephalic Version: Is it an Effective and Safe Procedure?

Published on: June 6, 2020

Area of Science:

Obstetrics and Gynecology
Maternal-Fetal Medicine

Background:

External cephalic version (ECV) is a procedure to externally manipulate a fetus from a breech to a cephalic presentation before labor.
Breech presentation at term is associated with increased risks during vaginal delivery, making ECV a crucial intervention.

Purpose of the Study:

To systematically review the literature on complications associated with external cephalic version.
To determine if the outcome of an ECV attempt (successful version vs. unsuccessful) is associated with the occurrence of complications.

Main Methods:

A comprehensive literature search was conducted in March 2007 across MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials.
Studies reporting on ECV complications in singleton breech pregnancies after 36 weeks were included. Odds ratios were calculated to assess the relationship between complications and fetal position post-procedure.

Main Results:

The review included 84 studies encompassing 12,955 ECV attempts.
The pooled complication rate was 6.1%, with serious complications at 0.24% and emergency cesarean deliveries at 0.35%.
Complications were not found to be related to the outcome of the ECV attempt (OR 1.2; 95% CI 0.93-1.7).

Conclusions:

External cephalic version is generally a safe obstetric procedure.
The occurrence of complications during ECV is not dependent on the success of the version attempt or the final fetal position.