External cephalic version - A 10-year review of practice. (March 2021)

• Record Type: Journal Article
• Authors: Hakem, Emmanuel; Lindow, Stephen W; O'Connell, Michael P; von Bünau, Günther
• Is Part Of: European journal of obstetrics, gynecology, and reproductive biology. Volume 258(2021)
• Page Start: 414
• Page End: 417
• Publication Date: 2021-03
• Subjects: External cephalic version -- ECV -- Breech -- Caesarean section; Obstetrics -- Periodicals; Gynecology -- Periodicals; Reproductive health -- Periodicals; Gynecology -- Periodicals; Obstetrics -- Periodicals; Reproduction -- Periodicals; Obstétrique -- Périodiques; Gynécologie -- Périodiques; Reproduction -- Périodiques; Verloskunde; Gynaecologie; Voortplanting (biologie); Gynecology; Obstetrics; Reproduction; Electronic journals; Periodicals; Electronic journals; 618.05
• DOI: 10.1016/j.ejogrb.2021.01.044
• Languages: English
• ISSNs: 0301-2115

Abstract

Abstract: Introduction: Following the term breech trial (TBT), the incidence of Caesarean section secondary to breech presentations increased, from 76.9 % to 89.7 %. External Cephalic Version (ECV) is a safe effective method to reduce non-cephalic presentation at time of delivery. Methods: Retrospective audit of all the ECV procedures performed at a tertiary women's hospital between Jan 2010 and Jan 2020. Results: The success rate of ECV was 54.5 %. The rate of vaginal birth following successful ECV was 73.6 % and rate of Caesarean 26.4 %, compared to 96.4 % for those with unsuccessful ECV (P < 0.0001). Factors found to be associated with increased success rates was the use of Intravenous terbutaline (P = 0.03), fetal birth weight ≥3.5 kg (P = 0.0001) and when the procedure is performed by an experienced operator who performed over 20 ECV procedures (P < 0.0001). Conclusion: ECV is a safe and effective procedure to reduce Caesarean section rates secondary to breech presentation. A dedicated ECV clinic with experienced operators and the use of intravenous terbutaline could improve success rate of ECV and reduce the number of Caesareans for breech presentation.