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Related Experiment Video

Updated: Mar 7, 2026

External Cephalic Version: Is it an Effective and Safe Procedure?
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Published on: June 6, 2020

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[Cord accident after external cephalic version: Reality or mostly myth?]

J Boujenah1, C Fleury2, I Pharisien1

  • 1Pôle femme et enfant, groupe hospitalier universitaire Paris Seine-Saint-Denis, site Jean-Verdier, avenue du 14-Juillet, 93140 Bondy, France; UFR SMBH, université Paris 13, Sorbonne Paris cité, 93000 Bobigny, France.

Gynecologie, Obstetrique, Fertilite & Senologie
|February 28, 2017
PubMed
Summary

External cephalic version (ECV) success or failure does not impact the risk of cord accidents. This study found no increased risk of cord accidents, including nuchal cords and prolapse, regardless of ECV outcome.

Keywords:
CesareanCirculaireCordCordonCésarienneExternal cephalic versionVME

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Area of Science:

  • Obstetrics and Gynecology
  • Perinatal Medicine
  • Fetal Presentation Management

Background:

  • External cephalic version (ECV) is a procedure to turn breech presentations to cephalic.
  • Cord accidents, such as nuchal cords and prolapse, are potential complications during labor and delivery.
  • Understanding the association between ECV outcomes and cord accidents is crucial for optimizing obstetric care.

Purpose of the Study:

  • To investigate the occurrence of cord accidents following external cephalic version (ECV).
  • To compare cord accident rates based on the success or failure of ECV.
  • To evaluate cord accident risks in relation to different delivery modes after ECV attempts.

Main Methods:

  • Retrospective study (1998-2015) involving 776 women with breech presentations.
  • Four groups were analyzed: successful ECV with trial of labor, failed ECV with subsequent delivery, spontaneous cephalic presentation, and breech presentation without ECV.
  • Cord accidents were diagnosed at delivery, comparing rates across groups and delivery interventions.

Main Results:

  • The overall prevalence of cord accidents did not significantly differ between women who underwent ECV attempts and those who did not.
  • Success or failure of ECV was not associated with a statistically significant difference in cord accident rates.
  • Trial of labor after failed ECV did not increase the risk of cord accidents compared to elective cesarean; cord prolapse was rare and observed only during trial of labor.

Conclusions:

  • External cephalic version (ECV) outcomes (success or failure) are not linked to an increased risk of cord accidents.
  • The management of breech presentation, whether through ECV or other means, should consider these findings to ensure maternal and fetal safety.
  • Further research could explore specific types of cord accidents and their nuanced relationship with ECV and labor management.