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Updated: May 17, 2026

External Cephalic Version: Is it an Effective and Safe Procedure?
08:49

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

Published on: June 6, 2020

External cephalic version for breech presentation at term.

G Justus Hofmeyr1, Regina Kulier

  • 1Department of Obstetrics and Gynaecology, East London Hospital Complex, University of the Witwatersrand, University of FortHare, Eastern Cape Department of Health, East London, South Africa. justhof@gmail.com.

The Cochrane Database of Systematic Reviews
|October 19, 2012
PubMed
Summary
This summary is machine-generated.

External cephalic version (ECV) significantly reduces non-cephalic births and cesarean sections for breech presentations. While complications are not fully assessed in trials, observational data suggest they are rare.

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Perinatal Care

Background:

  • Management of breech presentation remains controversial.
  • External cephalic version (ECV) is a procedure to manipulate fetal position.
  • ECV may decrease breech births and cesarean sections, but potential complications exist.

Purpose of the Study:

  • To evaluate the impact of ECV at or near term on pregnancy outcomes.
  • To review methods that facilitate ECV.
  • To separately review ECV performed before term.

Main Methods:

  • Searched the Cochrane Pregnancy and Childbirth Trials Register.
  • Included randomized trials comparing ECV at term with no ECV attempt in women with breech presentation.
  • Assessed eligibility, trial quality, and extracted data.

Main Results:

  • ECV significantly reduced non-cephalic births (RR 0.46) and cesarean sections (RR 0.63).
  • No significant differences were observed in Apgar scores, umbilical artery pH, neonatal admission, or perinatal death.
  • Time from enrollment to delivery showed no significant difference.

Conclusions:

  • Attempting ECV at term lowers the incidence of non-cephalic births and cesarean deliveries.
  • Evidence from randomized trials is insufficient to fully assess ECV complications.
  • Large observational studies indicate that ECV complications are infrequent.