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Updated: Apr 5, 2026
External Cephalic Version: Is it an Effective and Safe Procedure?
Published on: June 6, 2020
Probability of cesarean delivery after successful external cephalic version
Jorge Burgos1, María Iglesias1, José I Pijoan2
1Obstetrics and Gynecology Service, BioCruces Health Research Institute, Hospital Universitario Cruces (UPV/EHU), Barakaldo, Biscay, Spain.
Objective:
To identify factors associated with cesarean delivery following successful external cephalic version (ECV).
Methods:
In a prospective study, data were obtained for ECV procedures performed at Cruces University Hospital, Spain, between March 2002 and June 2012. Women with a singleton pregnancy who had a successful, uncomplicated ECV and whose delivery was assisted at the study hospital, with the fetus in cephalic presentation, were included. A multivariate model of risk factors of cesarean delivery was developed.
Results:
Among 627 women included, 92 (14.7%) delivered by cesarean. A cesarean was performed among 33 (8.5%) of 387 women with spontaneous labor versus 59 (24.6%) of 240 who were induced (P < 0.001). Multivariate analysis showed that higher BMI (P = 0.006), labor induction (P = 0.001), and prior cesarean (P < 0.001) were associated with cesarean. Time between ECV and delivery was inversely associated with probability of cesarean during the first 2 weeks. Thus, the probabilities of cesarean delivery on the first day were 0.53 (95% CI 0.35-0.71) and 0.34 (95% CI 0.18-0.51) following induced and spontaneous labor, respectively. On the seventh day, the probabilities were 0.23 (95% CI 0.15-0.32) and 0.12 (95% CI 0.07-0.18), respectively.
Conclusion:
Following ECV, induction of labor, an interval of less than 2 weeks to delivery, BMI, and previous cesarean were associated with an increased risk of cesarean.
