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Pregnancy outcome after successful external cephalic version for breech presentation at term
1Department of Obstetrics and Gynaecology, Chinese University of Hong Kong, Hong Kong.
American Journal of Obstetrics and Gynecology
|January 1, 1997
Summary
External cephalic version (ECV) at term increases the risk of intrapartum cesarean sections due to higher rates of fetal distress and dystocic labor. Close monitoring during labor is essential for pregnancies following successful ECV.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
Background:
- External cephalic version (ECV) is a procedure to turn a fetus from breech to cephalic presentation before labor.
- Successful ECV aims to reduce cesarean delivery rates, but outcomes require careful evaluation.
Purpose of the Study:
- To review pregnancy outcomes after term ECV.
- To determine the incidence and indications for intrapartum cesarean section following successful ECV.
Main Methods:
- Prospective study of 243 term ECV attempts in 241 pregnancies.
- Matched control group of cephalic presentation pregnancies for outcome comparison.
Main Results:
- ECV success rate was 69.5% (169/243), with 4.1% reverting to breech.
- Intrapartum cesarean section rate was 16.9% after successful ECV, 2.25 times higher than controls (p < 0.005).
- Higher rates of fetal distress, dystocic labor, and labor augmentation were observed in the ECV group.
Conclusions:
- Pregnancies with successful term ECV have different intrapartum risks compared to spontaneous cephalic presentations.
- Increased risk of dystocic labor and fetal distress necessitates vigilant intrapartum monitoring.