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External cephalic version: a clinical experience.

J P O'Grady, J C Veille, R L Holland

    Journal of Perinatal Medicine
    |January 1, 1986
    PubMed
    Summary
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    External cephalic version (ECV) successfully converted breech presentations in 62.5% of women, leading to cephalic infants and fewer operative deliveries. ECV is a valuable option to consider, potentially avoiding cesarean sections.

    Area of Science:

    • Obstetrics and Gynecology
    • Perinatal Medicine
    • Fetal Medicine

    Background:

    • Breech presentation complicates a significant percentage of late-term pregnancies.
    • Cesarean delivery is often recommended for breech presentation, carrying associated risks and costs.
    • External cephalic version (ECV) offers a non-invasive method to correct fetal malpresentation.

    Purpose of the Study:

    • To evaluate the success rate and outcomes of external cephalic version (ECV) for breech presentation in the late third trimester.
    • To identify factors influencing ECV success and failure.
    • To assess the impact of successful ECV on delivery mode and maternal/fetal complications.

    Main Methods:

    • Eighty-five women with breech presentation underwent ECV using real-time ultrasound and electronic fetal monitoring.

    Related Experiment Videos

  • Subcutaneous terbutaline sulfate was administered to 50.5% of candidates to facilitate the procedure.
  • A single operator used a head-over-heels technique with Trendelenburg positioning; Rh-negative women received immune globulin.

    • Main Results:

    • Successful ECV was achieved in 62.5% (53/85) of cases, significantly reducing the rate of operative delivery compared to ECV failures (9.8% vs 50%).
    • Success was correlated with maternal parity but not gestational age or delivery weight; breech engagement reliably predicted failure.
    • Fifty of 51 successfully verted infants were delivered cephalic at term, with only 9.8% requiring cesarean section for obstetric indications.

    Conclusions:

    • Late third-trimester ECV is an effective procedure for converting breech presentations to cephalic, leading to a high rate of vaginal cephalic delivery.
    • Successful ECV reduces the need for cesarean sections and operative vaginal deliveries, offering a potentially safer and more cost-effective alternative.
    • ECV should be seriously considered as an option for managing term breech presentations, especially given the risks associated with prematurity and operative deliveries.