External cephalic version at term — using tocolysis

Abstract

Fifty-five patients with non-vertex presentation at 37 to 40 weeks' gestation were evaluated to determine which factors were associated with a successful external cephalic version (ECV). Maternal parity, obesity, amniotic fluid volume, placental location, type of breech and position of fetal spine were analyzed. Only amniotic fluid volume and fetal weight were significantly associated with a successful version (p < 0.05), 40/55 (73%) were successfully converted, 36/55 (65%) were vertex at delivery, and 32/55 (58%) delivered vaginally. Version attempts were successful in six out of eight patients who had undergone a previous cesarean section. Two out of six of the successful version patients went on to have vaginal birth after cesarean section. We conclude that although ECV is a reasonable alternative in the management of pathological presentation near term it should be performed only when there is sufficient amniotic fluid volume.

A prospective study of the factors associated with the success rate of external cephalic version for breech presentation at term

“…Table 3 summarizes the results of previous studies [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20], and shows the wide inter-study variability. Other factors might affect the success rate of ECV, but are more difficult to measure.…”

“…Fetal weight estimated by ultrasound has been studied in various ways, for example as a continuous variable [2], according to different categories [6,9], or using the Fisher exact test [10], χ 2 test [11], or logistic regression analysis [17]. We consider that study of this variable, in light of its nature, requires a specific study design.…”

External cephalic version for breech presentation at term: predictors of success, and impact on the rate of caesarean section

“…Univariate analysis predominated in these reports, but this does not exclude the possibility of confounding effect between the variables [15][16][17][18].…”

“…It is recommended that all women with an uncomplicated breech pregnancy at term (37-42 weeks) should be offered ECV [1,9]. Although primarily intended for uncomplicated breech pregnancies at term, ECV has been carried out successfully in previous caesarean sections [10,11] and during early labour [7].…”

Pregnancy and obesity: practical implications

“…The success rate of external cephalic version (ECV) in cases of breech presentation is not influenced by obesity [121]. Even in morbidly obese patients, ECV has been carried out successfully [122].…”