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Updated: Jun 26, 2026
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External Cephalic Version: Is it an Effective and Safe Procedure?
Published on: June 6, 2020
Cesarean risk after successful external cephalic version: a matched, retrospective analysis.
1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Oregon Health Sciences University, Portland, OR 97239, USA. clockc@ohsu.edu
Summary
Successful external cephalic version (ECV) does not increase the rates of cesarean or operative vaginal delivery. These findings are similar for women with prior cesarean deliveries, aiding in counseling for ECV attempts.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
Background:
- External cephalic version (ECV) is a procedure to turn a fetus from a non-cephalic to a cephalic presentation before labor.
- Successful ECV aims to reduce the rate of cesarean delivery for breech presentations.
Purpose of the Study:
- To compare the rates of cesarean delivery, operative vaginal delivery, and vaginal birth after cesarean in singleton pregnancies after successful ECV versus eligible pregnancies undergoing a trial of labor.
- To evaluate the impact of successful ECV on delivery outcomes, particularly in women with a history of cesarean delivery.
Main Methods:
- A matched case-control study utilized the Memorial Care OBStat Database (1998-2006).
- 197 participants with successful ECV were compared to two matched controls for parity, gestational age, prior cesarean delivery, and labor type.
Main Results:
- No significant difference in adjusted odds of cesarean delivery was observed between the ECV group and controls (16.8% vs 11.9%).
- Operative vaginal delivery rates were also similar between groups (15.9% vs 8.9%).
- In women with a prior cesarean, the cesarean delivery rate was lower after successful ECV (11.1%) compared to controls (16.7%).
Conclusions:
- Successful ECV does not lead to increased rates of cesarean or operative vaginal delivery compared to matched controls.
- These findings support the use of ECV as a method to potentially increase vaginal birth rates and inform patient counseling for term breech presentations.
