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Predictors of successful external cephalic version at term: a prospective study
1Department of Obstetrics and Gynaecology, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong.
British Journal of Obstetrics and Gynaecology
|July 1, 1997
Summary
Predicting external cephalic version (ECV) success is possible using simple clinical factors. Engaged presenting part, difficult-to-palpate fetal head, and tense uterus predict ECV failure.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
Background:
- External cephalic version (ECV) is a procedure to turn a breech baby to a head-down position before birth.
- Predicting the success of ECV is crucial for optimizing obstetric management and reducing Cesarean births.
Purpose of the Study:
- To identify clinical and ultrasonographic predictors of successful external cephalic version (ECV) at term.
- To develop a predictive model for ECV outcomes.
Main Methods:
- Prospective observational study of 243 external cephalic versions at a university obstetric unit.
- Recorded 19 clinical and ultrasonographic variables, analyzed using univariate and logistic regression in subgroups.
- Validated predictive models on separate patient subgroups for accuracy and reproducibility.
Main Results:
- Overall ECV success rate was 69.5%.
- Three independent predictors of ECV failure identified: engaged presenting part, difficult-to-palpate fetal head, and tense uterus.
- Predictive models achieved 75.2% and 84.2% accuracy. Success rates ranged from 94% (no risk factors) to 0% (three risk factors).
Conclusions:
- External cephalic version outcomes can be reliably predicted using readily available clinical parameters.
- These predictors can aid in patient counseling and procedural planning for ECV.