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Updated: Jan 26, 2026

External Cephalic Version: Is it an Effective and Safe Procedure?
Published on: June 6, 2020
External cephalic version at term: A 6-year single-operator experience
Gabriel Levin1, Amihai Rottenstreich1, Yishay Weill2
1Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Background:
External cephalic version (ECV) should be offered for patients presenting with a noncephalic pregnancy that are willing to deliver vaginally. Various reports have evaluated predictors for successful ECV. Yet, none have reported a single-operator large cohort experience. We aim to analyze the outcome of referrals for ECV.
Methods:
We conducted a retrospective cohort study of prospectively collected data. We performed a multivariate analysis of data with respect to ECV procedures performed by a single operator in a 6-year period. Maternal and fetal characteristics were compared between ECV success and failure groups.
Results:
Six hundred and two women underwent ECV. Of them, ECV was successful in 432 (71.7%). A multivariate binary logistic regression model demonstrated that high liquor volume was a predictor of ECV success (Adj OR 1.17 [95% CI 1.09-1.26]). Failure of ECV was correlated with anterior placenta (0.44 [0.56-0.76]) and nulliparity (0.21 [0.11-0.36]). Adverse events were rare and mostly minor, occurring in 1% of procedures.
Conclusions:
ECV has a high success rate and a low complication rate, enabling vaginal birth and avoiding cesarean. The role of manipulation of modifiable determinants such as liquor volume should be further assessed in future studies.
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