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Related Experiment Video

Updated: Jun 12, 2025

External Cephalic Version: Is it an Effective and Safe Procedure?
08:49

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

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The Optimal Prediction Model for Successful External Cephalic Version.

Rahul S Yerrabelli1,2, Peggy K Palsgaard1,3, Priya Shankarappa1,4

  • 1Carle Illinois College of Medicine, The University of Illinois at Urbana-Champaign, Champaign, Illinois.

American Journal of Perinatology
|September 24, 2024
PubMed
Summary

External cephalic version (ECV) attempts can help prevent cesarean births for breech presentations. The Dahl 2021 prediction model shows the most promise for estimating ECV success, aiding patient counseling.

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Clinical Prediction Models

Background:

  • External cephalic version (ECV) is recommended to reduce cesarean deliveries for breech presentation.
  • Physician training in vaginal breech birth is limited, increasing reliance on ECV.
  • Accurate prediction of ECV success is crucial for shared decision-making and patient counseling.

Purpose of the Study:

  • To externally validate and compare the performance of six existing prediction models for ECV success.
  • To identify the most reliable model for predicting ECV outcomes in a U.S. hospital population.

Main Methods:

  • Retrospective analysis of 132 ECV attempts from 125 patients at Carle Foundation Hospital.
  • Evaluation of six prediction models: Dahl 2021, Bilgory 2023, López Pérez 2020, Kok 2011, Burgos 2010, and Tasnim 2012.
  • Assessment of predictive value using area under the curve (AUC) and calibration analysis.

Main Results:

  • Overall ECV success rate was 52.2% (69 out of 132 attempts).
  • Dahl 2021 demonstrated the highest predictive value (AUC: 0.779) and good calibration.
  • Tasnim 2012 performed poorly (AUC: 0.626), while other models showed moderate predictive values (AUC: 0.68-0.71).

Conclusions:

  • The Dahl 2021 model is the most promising tool for predicting ECV success among the validated models.
  • External validation of prediction models is essential for clinical adoption.
  • Accurate prediction models can significantly improve patient counseling regarding ECV attempts.