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Updated: Oct 22, 2025
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External Cephalic Version: Is it an Effective and Safe Procedure?
Published on: June 6, 2020
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External cephalic version at 38 weeks' gestation at a specialized German single center
Ann-Sophie Zielbauer1, Frank Louwen1, Lukas Jennewein1
1Department of Gynecology and Obstetrics, School of Medicine, Goethe-University, Frankfurt, Germany.
Plos One
|August 30, 2021
Summary
External cephalic version (ECV) at 38 weeks gestation is a safe procedure that can increase vaginal breech birth rates. This method offers a viable alternative to Cesarean sections, particularly in specialized centers.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Surgical Innovation
Background:
- Cesarean section (CS) rates are rising globally, with breech presentation at term being a common indication.
- External cephalic version (ECV) and vaginal breech delivery are established methods to reduce CS rates.
Purpose of the Study:
- To analyze the uptake, predictors, success rates, and complications of ECV at 38 weeks gestation.
- To evaluate ECV's role in reducing Cesarean sections for term breech presentation.
Main Methods:
- Prospective cohort study with retrospective data acquisition (2013-2017).
- Included women with singleton breech presentation after 34 weeks gestation.
- Logistic regression used to analyze ECV impact factors.
Main Results:
- ECV success rate was 22.4% in 353 patients.
- Predictors of success included later gestation, abundant amniotic fluid, fundal placental location, and oblique lie.
- No major complications were observed, increasing overall vaginal delivery rates by approximately 14%.
Conclusions:
- ECV at 38 weeks gestation is safe and effective in increasing vaginal breech delivery rates.
- Expertise in vaginal breech delivery and ECV can significantly reduce CS rates.
- Implementation of ECV and vaginal breech delivery training in medical curricula is recommended.
