Risk of developmental dysplasia of the hip in breech presentation: the effect of successful external cephalic version. Issue 5 (12th November 2012)

• Record Type: Journal Article
• Authors: Lambeek, AF; De Hundt, M; Vlemmix, F; Akerboom, BMC; Bais, JMJ; Papatsonis, DNM; Mol, BWJ; Kok, M
• Is Part Of: BJOG. Volume 120:Issue 5(2013:May)
• Page Start: 607
• Page End: 612
• Publication Date: 2012-11-12
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1111/1471-0528.12013
• Languages: English
• ISSNs: 1470-0328

Abstract

<abstract abstract-type="main" xml:lang="en"> <title> <x xml:space="preserve">Abstract</x> </title> <p> <italic>Please cite this paper as:</italic> Lambeek A, De Hundt M, Vlemmix F, Akerboom B, Bais J, Papatsonis D, Mol B, Kok M. Risk of developmental dysplasia of the hip in breech presentation: the effect of successful external cephalic version. BJOG 2012; DOI: 10.1111/1471‐0528.12013.</p> <p> <bold>Objective </bold> To evaluate the effect of successful external cephalic version on the incidence of developmental dysplasia of the hip (DDH) requiring treatment in singleton breech presentation at term.</p> <p> <bold>Design </bold> Observational cohort study.</p> <p> <bold>Setting </bold> Three large teaching hospitals in the Netherlands.</p> <p> <bold>Population </bold> Women with a singleton breech presentation of 34 weeks of gestation or more, who underwent an external cephalic version attempt.</p> <p> <bold>Methods </bold> We made a comparison of the incidence of DDH between children born in breech presentation and children born in cephalic presentation after a successful external cephalic version.</p> <p> <bold>Main outcome measure </bold> The incidence of DDH requiring either conservative treatment, with a harness, or surgical treatment.</p> <p> <bold>Results </bold> A total of 498 newborns were included in the study, of which 40 (8%) were diagnosed with DDH and 35 required treatment. Multivariate analysis showed that female gender (OR 2.79, 95% CI 1.23–6.35) and successful external cephalic version (OR 0.29, 95% CI 0.09–0.95) were independently associated with DDH.</p> <p> <bold>Conclusions </bold> A successful external cephalic version is associated with a lower incidence of DDH, although a high percentage of children born after a successful external cephalic version still appear to have DDH. A larger cohort study is needed to establish the definite nature of this relationship. Until then, we recommend the same screening policy for infants born in cephalic position after a successful external cephalic version as for infants born in breech position.</p> </abstract>