External cephalic version for breech presentation before term

Hofmeyr, G Justus

doi:10.1002/14651858.cd000084

Cited by 15 publications

(13 citation statements)

References 7 publications

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“…23 Blinding of clinicians and employment of a research midwife to interact with women also minimised contamination of women and care providers. Information included in the aid was based on seven systematic reviews of the management options for breech presentation at term 1,8,[24][25][26][27][28] and incorporation of effective evidence-based strategies for presenting patient information and risk communication. 20,[29][30][31] Findings show that the decision aid is effective in increasing informed decision making, with few women remaining undecided about their decision after use.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a decision aid for women with breech presentation at term: a randomised controlled trial [ISRCTN14570598]

Nassar

Roberts

Raynes-Greenow

et al. 2007

BJOG

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Objectives To evaluate the effectiveness of a decision aid for women with a breech presentation compared with usual care.Design Randomised controlled trial. Setting Tertiary obstetric hospitals offering external cephalic version (ECV).Population Women with a singleton pregnancy were diagnosed antenatally with a breech presentation at term, and were clinically eligible for ECV.Methods Women were randomised to either receive a decision aid about the management options for breech presentation in addition to usual care or to receive usual care only with standard counselling from their usual pregnancy care provider. The decision aid comprised a 24-page booklet supplemented by a 30-minute audio-CD and worksheet that was designed for women to take home and review with a partner.Main outcome measures Decisional conflict (uncertainty), knowledge, anxiety and satisfaction with decision making, and were assessed using self-administered questionnaires.Results Compared with usual care, women reviewing the decision aid experienced significantly lower decisional conflict (mean difference -8.92; 95% CI -13.18, -4.66) and increased knowledge (mean difference 8.40; 95% CI 3.10, 13.71), were more likely to feel that they had enough information to make a decision (RR 1.30; 95% CI 1.14, 1.47), had no increase in anxiety and reported greater satisfaction with decision making and overall experience of pregnancy and childbirth. In contrast, 19% of women in the usual care group reported they would have made a different decision about their care.Conclusions A decision aid is an effective and acceptable tool for pregnant women that provides an important adjunct to standard counselling for the management of breech presentation.

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Section: Discussionmentioning

confidence: 99%

Evaluation of a decision aid for women with breech presentation at term: a randomised controlled trial [ISRCTN14570598]

Nassar

Roberts

Raynes-Greenow

et al. 2007

BJOG

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“…The careful selection of low‐risk term participants in the trials published since the 1980s seems to have lowered the risks ( 10); currently, external cephalic version at term appears to be associated with an acceptable risk rate. Although in a recent report Kornman et al ( 11) encouraged a return to the practice of attempting gentle version before 37 weeks' gestation, a Cochrane review by Hofmeyr ( 12) still discouraged this practice.…”

Section: Discussionmentioning

confidence: 99%

Routine Use of External Cephalic Version in Three Hospitals

Regalia

Curiel

Natale

et al. 2000

Birth

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“…6,8,9 There is no strong evidence favoring ECV initiated close to term in primiparous women, and it has been suggested that it might be preferable to perform ECV earlier in pregnancy. 7,[10][11][12][13] The aim of the present study was to determine the optimum timing of ECV among primiparous women. The hypothesis was that initiating ECV before the descent of the breech fetus into the pelvisat a time when the ratio between fetal size and the quantity of amniotic fluid quantity is optimal-might increase the success rate of ECV and decrease the rates of both noncephalic presentation at birth and cesarean delivery.…”

Section: Introductionmentioning

confidence: 99%

Success rates of early versus late initiation of external cephalic version

Lavie

Reicher

Avraham

et al. 2019

Intl J Gynecology & Obste

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Objective To determine optimum timing of external cephalic version (ECV). Methods A retrospective cohort study was conducted at a tertiary hospital in Israel between February 1, 2016, and July 1, 2017. Healthy primiparous women with breech presentation were offered either early ECV (35–36 weeks; n=54) or late ECV (37–38 weeks; n=106). Group assignment was according to the patient's preference and physician availability. The primary outcome was the rate of cephalic presentation at delivery. Secondary outcomes included rate of cesarean delivery, presentation of fetus after the first and last ECVs, and serious fetal complications. Results The incidence of undergoing more than two ECV attempts was 18.5% in the early ECV group and 5.6% in the late ECV group (P=0.039). The incidence of cephalic presentation after the first ECV was 72.2% in the early ECV group versus 66.0% in the late ECV group (P=0.048). By contrast, no statistically significant between‐group differences were found for presentation at delivery or rate of cesarean delivery. The other outcomes were also similar. Conclusion Early initiation of ECV among primiparous women increased the chance of immediate cephalic presentation; however, it had no effect on presentation at delivery or cesarean delivery rate.

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External cephalic version for breech presentation before term

Cited by 15 publications

References 7 publications

Evaluation of a decision aid for women with breech presentation at term: a randomised controlled trial [ISRCTN14570598]

Evaluation of a decision aid for women with breech presentation at term: a randomised controlled trial [ISRCTN14570598]

Routine Use of External Cephalic Version in Three Hospitals

Success rates of early versus late initiation of external cephalic version

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