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External cephalic version after previous cesarean section: a series of 38 cases
J B de Meeus1, F Ellia, G Magnin
1Department of Obstetrics, Gynaecology and Reproductive Biology, University Hospital of Poitiers, France.
European Journal of Obstetrics, Gynecology, and Reproductive Biology
|December 10, 1998
Summary
External cephalic version (ECV) is a safe and effective procedure for breech presentation in women with a prior cesarean section. Successful ECV can lead to a vaginal birth after cesarean section, avoiding repeat cesarean delivery.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
Background:
- Breech presentation in women with a prior cesarean section poses a clinical challenge.
- Repeat cesarean section is a common approach, but carries risks.
- External cephalic version (ECV) offers a potential alternative to reduce cesarean rates.
Purpose of the Study:
- To evaluate the efficacy and safety of external cephalic version (ECV) as an alternative to repeat cesarean section for term breech presentation.
- To assess the subsequent vaginal birth after cesarean section (VBAC) success rate following successful ECV.
Main Methods:
- Retrospective study of 38 women with a previous cesarean section and term breech presentation who underwent ECV.
- Statistical analysis using Fisher's test (P<0.05).
Main Results:
- ECV was successful in 65.8% (25/38) of women.
- Of those with successful ECV, 76% achieved a vaginal birth after cesarean section.
- Overall, 50% (19/38) of women had a successful vaginal delivery.
- No maternal or neonatal complications were reported.
- ECV success was lower if breech was the indication for the prior cesarean section.
Conclusions:
- External cephalic version is an acceptable and effective procedure for women with a prior low transverse uterine scar and breech presentation.
- ECV can increase the likelihood of vaginal birth after cesarean section when safety criteria are met.