Spontaneous cephalic version of breech presentation in the last trimester

Westgren, Magnus; Edvall, Heléne; Nordström, Lars; Svalenius, Elizabeth Crang; Ranstam, Jonas

doi:10.1111/j.1471-0528.1985.tb01043.x

Cited by 90 publications

(49 citation statements)

References 8 publications

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“…They also have decreased placental weights, lower foetal-to-placenta ratio, shorter umbilical cords, and an increased incidence of inherited and acquired foetal diseases [19][20][21]. These findings are in agreement with the fact that the fetuses and newborns from breech presentation have an increased risk of unfavourable outcomes compared to cephalic presenting fetuses, regardless of the mode of delivery [22].…”

Section: The Impact Of Existing Data On Further Studiessupporting

confidence: 83%

Probability of breech presentation and its significance

Sekulić

Mikov

Petrovic

2010

The Journal of Maternal-Fetal & Neonatal Medicine

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Existing data related to the probability of breech presentation suggest that the breech presentation is a consequence of mere filling of the intrauterine space, with the same probability of breech and cephalic presentation. As a consequence, group of cephalic presenting fetuses is heterogeneous. Some fetuses randomly assume the cephalic presentation while others assume cephalic presentation 'intentionally' for a reason. Before comparing breech and cephalic presenting fetuses/newborns, bias should be eliminated by subtracting from the cephalic-presenting group the number of fetuses/newborns that is identical with the number of breech-presenting fetuses/newborns with identical characteristics. The subtracted group should be added to the breech-presenting group before comparison with the remaining cephalic-presenting fetuses/newborns. The comparison should be corrected for the gestational age and according to data that are not influenced by delivery. Data suggest that the physiological process that accounts for 92% of cephalic-presenting human fetuses at delivery should be sought from the 25th gestational week onwards.

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Section: The Impact Of Existing Data On Further Studiessupporting

confidence: 83%

Probability of breech presentation and its significance

Sekulić

Mikov

Petrovic

2010

The Journal of Maternal-Fetal & Neonatal Medicine

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“…It is known that higher gestational age and nulliparity versus lower gestational age and multiparity tend to reduce the rate of spontaneous version. 1 Do et al 13 found a trend towards an increase in cephalic version at delivery for women receiving moxibustion compared with usual care, but the study was underpowered to detect statistical differences between groups. Our study confirms the findings of the systematic review in terms of safety, adding more evidence in favour of moxibustion as a safe technique for pregnant women.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of non-vertex or breech presentation is 20% at 28 weeks of gestation, although spontaneous version frequently occurs, 1 so only in 3-4% of women with a full-term singleton pregnancy is the fetus in a non-vertex presentation. 2 In Spain, non-vertex presentations represents 3.8% of all births.…”

Section: Introductionmentioning

confidence: 99%

Using Moxibustion in Primary Healthcare to Correct Non-Vertex Presentation: A Multicentre Randomised Controlled Trial

et al. 2013

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Objective To compare the effectiveness of additional moxibustion at point BL67 with moxibustion at a non-specific acupuncture point and with usual care alone to correct non-vertex presentation. Methods This was a multicentre randomised controlled trial in which 406 low-risk pregnant women with a fetus in ultrasound breech presentation, with a gestational age of 33-35 weeks, were assigned to (1) true moxibustion at point BL67 plus usual care; (2) moxibustion at SP1, a non-specific acupuncture point (sham moxibustion) plus usual care; or (3) usual care alone. The primary outcome was cephalic presentation at birth. Women were recruited at health centres in primary healthcare. Results In the true moxibustion group, 58.1% of the full-term presentations were cephalic compared with 43.4% in the sham moxibustion group (RR 1.34, 95% CI 1.05 to 1.70) and 44.8% of those in the usual care group (RR 1.29, 95% CI 1.02 to 1.64). The reduction in RR of the primary outcome in women allocated to the true moxibustion group compared with the usual care group was 29.7% (95% CI 3.1% to 55.2%) and the number needed to treat was 8 (95% CI 4 to 72). There were no severe adverse effects during the treatment. Conclusions Moxibustion at acupuncture point BL67 is effective and safe to correct non-vertex presentation when used between 33 and 35 weeks of gestation. We believe that moxibustion represents a treatment option that should be considered to achieve version of the non-vertex fetus.

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“…7, 8 Westgren et al reported a spontaneous version rate of 46% for primigravidas, 32% for multigravidas with a previous breech presentation, and 78% for multigravidas without previous breech. 9 Both the cases presented here were primigravidas and at 37 weeks of gestation. This decreases the chance of spontaneous version, thus avoiding unnecessary acupuncture intervention.…”

Section: Discussionmentioning

confidence: 89%

Cephalic Conversion of Breech by Acupuncture

Kuruvilla¹,

Kresin²

2007

Medical Acupuncture

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Background: Cephalic conversion of breech presentation at various gestational ages by acupuncture has been reported in Chinese and European acupuncture literature. Such reports may not have been published in the United States.Objective: To describe experience with two cases of cephalic conversion. Design, Patients, and Setting: Two women at 37 weeks' gestation with ultrasound-confirmed breech presentation consented for a trial of acupuncture for conversion.Intervention: Needling of BL 67 for 20 minutes. Main Outcome Measures: Fetal presentation at delivery; secondary outcome was fetal heart rate during acupuncture.Results: Both fetuses were in vertex presentation at delivery. Fetal heart rates were not greatly affected by the intervention.Conclusion: Acupuncture and moxibustion are possible modalities for cephalic conversion in uncomplicated pregnancies. Clinical trials should be conducted to confirm this approach in the United States.

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Spontaneous cephalic version of breech presentation in the last trimester

Cited by 90 publications

References 8 publications

Probability of breech presentation and its significance

Probability of breech presentation and its significance

Using Moxibustion in Primary Healthcare to Correct Non-Vertex Presentation: A Multicentre Randomised Controlled Trial

Cephalic Conversion of Breech by Acupuncture

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