Factors Associated with Attempted External Cephalic Version for Fetal Malpresentation at Term

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine

Background:

• Fetal malpresentation at term, such as breech presentation, complicates delivery.
• External cephalic version (ECV) is a procedure to turn the fetus to a cephalic presentation before labor.
• Understanding patient characteristics associated with ECV uptake is crucial for informed decision-making.

Purpose of the Study:

• To compare patient demographics and clinical factors between women who underwent attempted external cephalic version (ECV) and those who did not.
• To identify reasons why women with fetal malpresentation at term declined attempted ECV.

Main Methods:

• Retrospective cohort study of singleton gestations with noncephalic presentation at >37.0 weeks.
• Comparison of demographic and clinical characteristics of women who did and did not undergo attempted ECV.
• Analysis of reasons for declining ECV.

Main Results:

• Only 24% of 215 women attempted ECV.
• Women who underwent ECV were significantly more likely to have had a prior vaginal delivery (69% vs. 36%).
• Nulliparous women were more likely to decline ECV (66% vs. 29%). ECV success rate was 55% with no adverse events.

Conclusions:

• Women without a prior vaginal delivery were significantly less likely to undergo attempted ECV for fetal malpresentation at term.
• Parity appears to be a significant factor influencing the decision to attempt ECV.
• Further research may explore barriers and facilitators to ECV uptake in nulliparous women.