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When does external cephalic version succeed?

A C Hellström¹, B Nilsson, L Stånge

¹Department of Obstetrics and Gynecology, Karolinska Institutet Huddinge University Hospital, Sweden.

Acta Obstetricia Et Gynecologica Scandinavica

|January 1, 1990

Summary

External cephalic version (ECV) successfully repositioned fetuses in 58% of cases. Parity, fetal presentation, and amniotic fluid volume significantly influenced ECV success rates in pregnant women.

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Area of Science:

Obstetrics and Gynecology
Maternal-Fetal Medicine

Background:

Fetal malpresentation, particularly breech presentation, is a common indication for external cephalic version (ECV).
Successful ECV can potentially reduce the rate of cesarean deliveries.
Factors influencing ECV success require further elucidation for optimized clinical practice.

Purpose of the Study:

To identify factors associated with successful external cephalic version (ECV) in pregnant women with fetal malpresentations.
To determine the overall success rate of ECV and analyze its predictors.

Main Methods:

A consecutive series of 300 pregnant women with fetal malpresentations underwent attempted ECV during the last trimester.
Multivariate logistic regression analysis was employed to identify significant predictors of successful version among 16 variables.

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Data were collected between 1984 and 1987.

Main Results:

The overall ECV success rate after one or more attempts was 58%.
Success rates were significantly lower in nulliparous women (39%) compared to parous women (80%).
Parity, fetal presentation, and amniotic fluid volume were identified as independent predictors of successful ECV.

Conclusions:

Parity is the most significant factor influencing ECV success, with parous women experiencing higher success rates.
Fetal presentation and amniotic fluid volume also play crucial roles in the success of external cephalic version.
These findings can aid in patient selection and counseling for ECV procedures.