The present study shows that there is no general consensus on the eligibility of patients for ECV. Therefore we propose to limit contraindications for ECV to clear empirical evidence or to those with a clear pathophysiological relevance.
External cephalic version (ECV) is often recommended to avoid a cesarean delivery (CD) in women with a fetus in the breech position. International guidelines recommend that all women with an uncomplicated breech pregnancy at term should be offered an ECV. These guidelines also list contraindications to ECV; however, excluding patients from ECV in the presence of only 1 clinical factor that could affect its success rate is undesirable. This systematic review was performed to determine whether the contraindications to ECV in guidelines are consistent and based on empirical data and to offer recommendations for ECV contraindications.Guidelines and databases were identified and searched for studies reporting on ECV and citing contraindications. All studies reporting on ECV in a singleton pregnancy from 36 weeks without a contraindication for vaginal delivery were selected. Contraindications were categorized as maternal, fetal, and other factors.The electronic search for guidelines found 5 sets that reported on 18 contraindications, with 5 to 13 contraindications per guideline. The literature search provided 890 studies on ECV; of 261 retrieved, 60 articles were assessed and reported on 39 different contraindications to ECV. Forty-three studies were cohort studies, 6 were case-control studies,
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