Predictors of Cephalic Vaginal Delivery Following External Cephalic Version: An Eight-Year Single-Centre Study of 447 Cases

Abstract

Introduction. Our study aims to investigate and evaluate (1) rates of success of ECV for breech presentation at term at the Royal Women's Hospital in comparison to international standards; (2) mode of delivery following ECV; (3) factors influencing success rates of ECV at the Royal Women's Hospital. Methods. An audit of all women who underwent ECV between the years 2007 and 2014 at the Royal Women's Hospital as public patients was completed. Data parameters were collected from paper and electronic patient files at the Women's Hospital. Data was collected to analyse the effect of the following parameters on ECV success and birth outcome: age, parity, gestational age, BMI, AFI, and tocolytic use. These parameters were analysed to determine their effect on ECV outcome and birth outcome. Results. The Women's Hospital, Melbourne, has an ECV success rate of approximately 37%. Of the patients undergoing ECV, 29% proceeded to normal vaginal delivery. Predictors of successful ECV included low BMI, multiparity, and AFI more than 16 (P < 0.05). The only predictor of cephalic vaginal delivery following ECV was multiparity. Negative predictors of cephalic delivery were low AFI and nulliparity. Conclusions. The success rate of ECV at the Women's Hospital, Melbourne, is in line with global standards.

What if something goes wrong? A grounded theory study of parents’ decision-making processes around mode of breech birth at term gestation

“…A key emphasis since the TBT has been to offer women with a breech presentation external cephalic version. Several large, long-term cohort studies have recently been published to evidence safety, predictors of success, and perinatal outcomes, albeit with an overwhelming focus on high resource settings (Melo et al, 2018;Andrews et al, 2017;Kew et al, 2017;Hutton et al, 2017;Rodgers et al, 2017;Weiniger et al, 2016;Basu et al, 2016). The PREMODA (PREsentation et MODe d'Accouchement) trial used the same criteria and outcome measures as the TBT to address its methodological flaws, but removed the randomised element (Goffinet et al, 2006).…”

Assessment of the Successful External Cephalic Version Prognostic Parameters Effect on Final Mode of Delivery

“…These findings are consistent with a study that was reported in Taif, Saudi Arabia that showed 84.1% of the women delivered vaginally and 14.5% of them underwent cesarean section after a successful ECV. It is suggested that ECV should be offered to all women with a breech presentation to minimize the danger of non-cephalic presentation at term and decrease the risk of cesarean section [ 13 ].…”

Experiences with High Success Rate of External Cephalic Version and Comparisons of Different Tocolysis for Risk-effective version based on a bayesian network meta-analysis

“…It is worth mentioning that though amnioinfusion and oral hydration could improve the amount of amniotic uid, which could not obviously improve the success rate of ECV [14,40]. Stature of the candidates was the second important indicator to select the candidates during our procedure, because thickness of the abdominal wall directly affect the di culty of grasping of the fetal head and buttocks [41,42]. BMI of the patients ranged from 21.5 to 31.6 in our study, with no difference between the successful and failed group, which might due to the strict screening criteria in our institution.…”