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Related Experiment Video

Updated: May 14, 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

Patient's willingness to opt for external cephalic version.

Floortje Vlemmix1, Marjon Kuitert, Joke Bais

  • 1Department of Obstetrics and Gynecology, AMC, Amsterdam, the Netherlands. f.vlemmix@amc.nl

Journal of Psychosomatic Obstetrics and Gynaecology
|February 12, 2013
PubMed
Summary

Patient willingness to undergo external cephalic version (ECV) for breech presentation is most influenced by expected pain and success rates. Improving counseling on these factors may increase ECV uptake and reduce cesarean sections.

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine

Background:

  • External cephalic version (ECV) is a procedure to turn a breech baby to a head-down position.
  • ECV can reduce the rate of cesarean sections (CS) for breech presentation.
  • Current ECV uptake is suboptimal, with only up to 70% of eligible patients opting for the procedure.

Purpose of the Study:

  • To investigate patient preferences regarding various aspects of ECV.
  • To identify key factors influencing women's willingness to undergo ECV.
  • To inform improved counseling strategies for ECV.

Main Methods:

  • A vignette study was conducted to assess patient preferences.
  • 16 scenarios with varying treatment characteristics were presented.
  • Logistic regression was used to estimate the probability of preferring ECV over elective CS.

Main Results:

  • Pain was the most significant factor negatively impacting ECV willingness (OR 0.11 for high pain scores).
  • Higher success rates for vaginal delivery post-ECV increased willingness (OR 3.42).
  • The risk of emergency CS during ECV did not significantly influence willingness (OR 0.83).

Conclusions:

  • Expected pain and success rate are primary drivers of patient willingness for ECV.
  • Counseling should address patient concerns about pain and emphasize success rates.
  • Reassurance that pain is manageable and ECV can be stopped if severe may improve uptake.