Identification of independent predictors of successful external cephalic version: A retrospective multicenter study

This study aimed to determine the success rate of external cephalic version (ECV) and identify independent predictors of successful ECV among women with a term singleton fetus in breech presentation. This retrospective multicenter study included 65 pregnant women who underwent ECV at 2 centers between January 2017 and January 2024. Participants were categorized into successful (n = 39) and failed (n = 26) ECV groups. Univariate analyses and multivariable logistic regression were used to identify independent predictors of successful ECV. The overall ECV success rate was 60.0% (39/65). Multivariable analysis showed that multiparity (odds ratio [OR], 5.54; 95% confidence interval [CI], 1.52-20.12; P = .009) and a nonanterior placental location (OR, 4.72; 95% CI, 1.31-17.03; P = .018) were independent positive predictors of ECV success. Maternal body mass index showed a borderline inverse association with success (OR, 0.84; 95% CI, 0.70-1.00; P = .053). No severe maternal or neonatal complications occurred. Vaginal delivery was achieved by 89.7% of women in the successful ECV group and none in the failed ECV group (P < .001). Multi parity and a nonanterior placental location were associated with greater odds of successful ECV. Pre procedural assessment of these factors may support individualized counseling and clinical decision-making aimed at reducing cesarean delivery rates.