Uptake of external cephalic version for term breech presentation: an Australian population study, 2002-2012

Area of Science:

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

Background:

• External cephalic version (ECV) is a safe and effective procedure for term breech presentation.
• Clinical guidelines recommend ECV for eligible women.
• ECV uptake in Australia is not well-documented.

Purpose of the Study:

• To determine the uptake of ECV in New South Wales, Australia, between 2002 and 2012.
• To compare characteristics of women who underwent ECV with those eligible but did not.
• To examine birth outcomes following successful and unsuccessful ECV procedures.

Main Methods:

• Retrospective analysis of hospital and birth records for singleton breech pregnancies at ≥36 weeks' gestation.
• Comparison of women who had ECV versus those eligible but not treated.
• Analysis of birth outcomes based on ECV success.

Main Results:

• Only 10.5% of 32,321 singleton breech pregnancies underwent ECV.
• Women who had ECV were more likely to be older, multiparous, and deliver in urban tertiary hospitals.
• Caesarean section rates were 25.9% after successful ECV and 95.6% after unsuccessful ECV; infant outcomes were similar.

Conclusions:

• The majority of women with term breech presentation did not receive ECV, indicating low uptake.
• Barriers to ECV uptake may involve service provision or patient acceptance.
• Improved data collection and policies are needed to enhance ECV access and information for eligible women.