Improving external cephalic version for foetal breech presentation

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine

Background:

• External cephalic version (ECV) aims to convert a breech presentation to a cephalic one, potentially reducing caesarean sections.
• The success rate of ECV and its impact on delivery outcomes require further investigation, especially concerning factors influencing success.

Purpose of the Study:

• To evaluate the success rate of ECV for term breech presentations.
• To identify factors associated with successful ECV.
• To analyze the labor outcomes for all term breech presentations.

Main Methods:

• Retrospective cohort study including all women with a term breech presentation.
• Logistic regression analyses were used to identify associations between patient characteristics and ECV success.

Main Results:

• The overall ECV success rate was 19%.
• Maternal and fetal complications were negligible post-ECV.
• Body Mass Index (BMI), type of breech presentation, and amniotic fluid volume were significantly correlated with ECV success.
• The rate of primary caesarean sections was lower in the ECV group (52.9%) compared to the non-ECV group (79.6%).
• Spontaneous delivery rates were higher after ECV (36%) versus no ECV (12%).

Conclusions:

• The overall success rate of ECV for term breech presentation is low at 19%.
• BMI, breech type, and amniotic fluid volume are significant predictors of ECV success.
• ECV is associated with a significant reduction in primary caesarean sections and an increase in spontaneous deliveries.