[External version in the breech presentation: a review of the literature and our experience]

To evaluate the possibility to decrease the rate of cesarean delivery for breech presentation through use of a protocol that calls for cephalic version.

Between january 1991 and april 1994 we offered cephalic version under tocolysis to patients whose fetuses were in breech position beyond 36 weeks' gestation and who were not in active labor. The protocol included real time ultrasonic scanning and pre- and post-procedure electronic fetal monitoring. A variety of maternal and fetal factors considered likely to affect success were coded for each patient.

The conditions for an attempt at external cephalic version were satisfied in 47 cases. External version was accomplished in 32 cases (68%). Among patients in whom version was successful 20% required cesarean delivery for routine obstetrical indications. No major complications were noted. Successful version was more likely in women with amniotic fluid index > 50 and in those with posterior placental situation.

We conclude from our experience and previous studied that the external cephalic version is a reasonable alternative in the management of pathological presentations near term, provided that only low risk pregnancies are included.