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External Cephalic Version: Is it an Effective and Safe Procedure?
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External Cephalic Version: Is it an Effective and Safe Procedure?

Javier Sánchez-Romero1, Vanesa García-Soria2, Fernando Araico-Rodríguez1

  • 1Department of Obstetrics & Gynecology, "Virgen de la Arrixaca", University Clinical Hospital.

Journal of Visualized Experiments : Jove
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Summary

External cephalic version (ECV) successfully converts breech presentations to cephalic, reducing cesarean sections. Factors like previous vaginal delivery and maternal BMI influence ECV success rates.

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine

Background:

  • External cephalic version (ECV) is a procedure to externally manipulate a fetus from a breech to a cephalic presentation.
  • ECV is effective in reducing cesarean sections for breech presentations, but standardized protocols and success factor analyses are crucial.

Purpose of the Study:

  • To demonstrate the methodology of ECV using a specific protocol including tocolysis and analgesia.
  • To analyze factors associated with successful ECV and compare delivery outcomes with the general pregnant population.

Main Methods:

  • Retrospective analysis of 320 ECV procedures performed between 2014-2018 at a major Spanish maternity center.
  • Data collected included gestational age, tocolysis, analgesia, ECV success rates, complications, and delivery outcomes.

Main Results:

  • ECV was successful in 82.5% of cases (N=264) at a mean gestational age of 37±3 weeks.
  • Complications were reported in 5.9% of cases, including vaginal bleeding and fetal bradycardia.
  • Previous vaginal delivery (ORadjusted=3.03) and lower maternal BMI (ORadjusted=0.94) were associated with higher ECV success rates.

Conclusions:

  • ECV is an effective procedure for reducing cesarean sections in breech presentations.
  • Maternal BMI and prior vaginal delivery are key factors influencing ECV success.
  • Successful ECV does not alter the overall delivery pattern, but may increase instrumented vaginal delivery rates.