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Related Experiment Videos

[The benefit of external version in full-term breech presentation].

R van de Pavert1, J Bennebroek Gravenhorst, M J Keirse

  • 1Academisch Ziekenhuis, afd. Verloskunde, Leiden.

Nederlands Tijdschrift Voor Geneeskunde
|November 17, 1990
PubMed
Summary

External cephalic version (ECV) for breech presentation showed minimal impact on birth presentation but unexpectedly increased C-section rates. Tocolysis may improve ECV success and influence delivery method decisions.

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine

Background:

  • Breech presentation complicates approximately 3-5% of term pregnancies.
  • External cephalic version (ECV) is a procedure to manually turn a fetus from breech to cephalic presentation before labor.
  • The efficacy and safety of ECV, particularly in relation to delivery mode, require ongoing investigation.

Purpose of the Study:

  • To evaluate the effectiveness of external version in reducing breech presentation at birth.
  • To assess the impact of external version on the rate of cesarean sections.
  • To explore the role of tocolysis in the success of external version.

Main Methods:

  • A randomized controlled trial involving 52 women with breech presentation after 36 weeks' gestation.
  • Participants were randomized to undergo external version or standard management.

Related Experiment Videos

  • Success rates of ECV with and without tocolysis were recorded, alongside rates of breech presentation and cesarean delivery.

    • Main Results:

    • External version slightly decreased breech presentation at birth (64% vs. 74%).
    • A significant, unexpected increase in cesarean section rates was observed (28% vs. 11%).
    • ECV success without tocolysis was low (5%), but increased to 31% with subsequent tocolysis.

    Conclusions:

    • External version at term may not benefit populations with low cesarean rates.
    • Maximal efficiency, potentially through tocolysis, or indifference to failed attempts is crucial for ECV.
    • Failed ECV attempts appear to significantly influence the decision between abdominal and vaginal delivery.