External Cephalic Version
Published Date: 19th July 2016
Publication Authors: Idama TO
Background
The term breech trial renewed interest in the procedure of external cephalic version (ECV). It is now recommended that ‘ECV should be discussed and offered to all women with uncomplicated breech presentation at term’.
Objective
To assess the outcome of ECV in our clinical setting.
Methods
This was a retrospective cohort study in a UK District General Hospital with patients who had undergone ECV during the time period of 1st January 2001 and 31st December 2011. The protocol included ultrasound scanning and pre- and postprocedure electronic fetal monitoring. Tocolysis in the form of either intramuscular Ritodrine 10 mg or subcutaneous Terbutaline 500 mcg was administered 10–20 min before starting ECV. A single operator, backward roll or forward roll technique was used. A maximum of three attempts, each lasting 3 min was undertaken. An audit form was partly filled in after each procedure and left in a designated file on delivery suite; the form was completed when the woman delivered. The main outcome measures were success rate of ECV; rate of vaginal delivery following ECV and any complications of ECV.
Results
Three hundred and seventy-one ECVs were performed on 361 women. Overall success rate was 64% (49% in Nulliparous versus 81% for Multiparous). Overall, 84% of successful ECVs achieved a cephalic vaginal delivery (75% Nulliparous vs. 90% Multiparous). Overall, caesarean section rate in women where ECV was attempted was 45% which was decreased to 16% in women with successful ECV. There were no significant ECV related complications in our series.
Conclusions
Successful ECV at term substantially reduces the number of women undergoing caesarean section for breech presentation.
Idama, TO. (2013). Outcome of external cephalic version for breech at term: An audit of 11 years experience in a UK district general hospital . BJOG: An International Journal of Obstetrics and Gynaecology. 120 (Supplement), 127-8
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