External cephalic version after previous cesarean section: A cohort study of 100 consecutive attempts

Area of Science:

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

Background:

• External cephalic version (ECV) is infrequently performed in women with a prior cesarean section due to concerns about uterine rupture and subsequent cesarean delivery.
• The actual risks associated with ECV in this population remain unclear.

Purpose of the Study:

• To evaluate the safety and efficacy of ECV in women with a history of cesarean section.
• To document outcomes in a series of 100 consecutive ECV attempts.
• To review existing literature on ECV in women with prior cesarean delivery.

Main Methods:

• Retrospective cohort study of prospectively collected data from 100 women with a prior cesarean section undergoing ECV at term.
• Literature review of published series involving 549 cases.
• ECV performed by experienced operators using ultrasound guidance and salbutamol tocolysis when appropriate.

Main Results:

• The ECV success rate was 50% in the studied cohort.
• Of those with successful ECV, 63.8% achieved a vaginal birth.
• No instances of uterine rupture or other complications were reported in the 100 cases or in the literature review (549 cases).

Conclusions:

• External cephalic version is a safe procedure for women with a prior cesarean section.
• While safe, ECV facilitates a vaginal birth in approximately one-third of women in this group.