Effectiveness and Safety of External Cephalic Version in Full-Term Breech Presentations: Retrospective Study

Area of Science:

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

Background:

• External cephalic version (ECV) is crucial for converting abnormal fetal presentations to cephalic in term pregnancies.
• ECV aims to reduce cesarean delivery rates by addressing non-cephalic fetal positions.

Purpose of the Study:

• To evaluate the effectiveness of external cephalic version (ECV) in a high-volume tertiary obstetric center.
• To identify factors influencing the success rate of ECV procedures.

Main Methods:

• A retrospective observational study included 365 women with singleton term pregnancies and non-cephalic presentations undergoing attempted ECV.
• Data on maternal characteristics, procedural variables, and delivery outcomes were analyzed using univariate and multivariate logistic regression.

Main Results:

• The overall success rate for ECV was 64.9% (237/365 patients).
• Management by a specialized disease team (aOR 3.262) and multiparity (aOR 2.374) were significantly associated with higher ECV success.
• An anterior placental location was associated with significantly lower ECV success (aOR 0.495).

Conclusions:

• Specialized team management and multiparity are key predictors of successful ECV.
• Anterior placental location presents a significant challenge to successful ECV.
• Findings can inform clinical protocols to optimize ECV outcomes and reduce cesarean rates.