Successful external cephalic version is an independent factor for caesarean section during trial of labor – a matched controlled study

Boujenah, J.; Fleury, Cynthia; Bonneau, Claire; Pharisien, I.; Tigaizin, A.; Carbillon, Lionel

doi:10.1016/j.jogoh.2017.09.001

Cited by 10 publications

(2 citation statements)

References 27 publications

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“…Spontaneous reversion to the breech position after successful ECV occurs in less than 5% of cases 4,5 . In addition, a higher CS rate has been described in pregnant women who start labor with fetuses in the cephalic position after successful ECV 6–8 . However, even taking into account the latter two circumstances, the use of ECV has been shown to decrease the rate of CS resulting from breech presentation at term 9 …”

Section: Introductionmentioning

confidence: 99%

Prediction model of success for external cephalic version. Complications and perinatal outcomes after a successful version

López-Pérez

Lorente-Fernández

Velasco-Martínez

et al. 2020

J of Obstet and Gynaecol

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Aim: External cephalic version (ECV) is an effective and safe technique for avoiding breech presentation at birth. However, it continues rejected by many women. The aim of this study is to develop a predictive model of success of external cephalic version, determine the safety of the technique and perinatal outcomes after successful version. Methods: Data from 317 versions performed over a 6-year period were collected. Different clinical and ultrasound variables, complications, vaginal delivery after successful version and perinatal outcomes were analyzed. Results: The overall success rate was 72% (229 of 317 versions). The variables most related to success were parity, placental location, amniotic fluid volume, fetal sex, fetal head palpation and descent of the presenting part. A model for calculating the probability of success was developed in which to input parity, placentation and amniotic fluid data. The model correctly classified 98.8% of successful technique and 74% of all women. Complications were very few and mostly mild. Of women who had success, 77% (163 of 212) had a vaginal birth. No differences between neonatal outcomes were found. Conclusion: External cephalic version is a successful, safe technique with a high rate of subsequent vaginal delivery. A success prediction model based on some very easily obtained variables can personalize the probability of success.

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Section: Introductionmentioning

confidence: 99%

Prediction model of success for external cephalic version. Complications and perinatal outcomes after a successful version

López-Pérez

Lorente-Fernández

Velasco-Martínez

et al. 2020

J of Obstet and Gynaecol

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“…De Hundt et al [54] conducted a systematic review and meta-analysis and showed that women who have had a successful ECV for breech presentation are at increased risk for CS delivery (OR 2.2; 95% CI 1.6-3.0) and instrumental vaginal delivery (OR 1.4; 95% CI 1.1-1.7) compared with women with spontaneous cephalic presentation. Interestingly, stratification by time delay between successful ECV and delivery revealed a trend for increased risk of CS during the first week after ECV [55]. Furthermore, in a cohort of 301 women with successful ECV, De Hundt et al [56] found that nulliparity was the only of seven factors that predicted the risk of CS and instrumental vaginal delivery (OR 2.7; 95% CI 1.2-6.1).…”

Section: Obstetric Outcomes After An Ecv Attemptmentioning

confidence: 99%

Revisiting the management of term breech presentation: a proposal for overcoming some of the controversies

Carbillon

Benbara

Tigaizin

et al. 2020

BMC Pregnancy Childbirth

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Background: The debate surrounding the management of term breech presentation has excessively focused on the mode of delivery. Indeed, a steady decline in the rate of vaginal breech delivery has been observed over the last three decades, and the soundness of the vaginal route was seriously challenged at the beginning of the 2000s. However, associations between adverse perinatal outcomes and antenatal risk factors have been observed in foetuses that remain in the breech presentation in late gestation, confirming older data and raising the question of the role of these antenatal risk factors in adverse perinatal outcomes. Thus, aspects beyond the mode of delivery must be considered regarding the awareness and adequate management of such situations in term breech pregnancies. Main body: In the context of the most recent meta-analysis and with the publication of large-scale epidemiologic studies from medical birth registries in countries that have not abruptly altered their criteria for individual decisionmaking regarding the breech delivery mode, the currently available data provide essential clues to understanding the underlying maternal-foetal conditions beyond the delivery mode that play a role in perinatal outcomes, such as foetal growth restriction and gestational diabetes mellitus. In view of such data, an accurate evaluation of these underlying conditions is necessary in cases of persistent term breech presentation. Timely breech detection, estimated foetal weight/growth curves and foetal/maternal well-being should be considered along with these possible antenatal risk factors; a thorough analysis of foetal presentation and an evaluation of the possible benefit of external cephalic version and pelvic adequacy in each specific situation of persistent breech presentation should be performed. Conclusion: The adequate management of term breech pregnancies requires screening and the efficient identification of breech presentation at 36 weeks of gestation, followed by thorough evaluations of foetal weight, growth and mobility, while obstetric history, antenatal gestational disorders and pelvis size/conformation are considered. The management plan, including external cephalic version and follow-up based on the maternal/foetal condition and potentially associated disorders, should be organized on a case-by-case basis by a skilled team after the woman is informed and helped to make a reasoned decision regarding delivery route.

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Influence of the external cephalic version attempt on the Cesarean section rate: experience of a type 3 maternity hospital in France

Birene¹,

Ishaque²,

Chrusciel

et al. 2020

Arch Gynecol Obstet

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Successful external cephalic version is an independent factor for caesarean section during trial of labor – a matched controlled study

Cited by 10 publications

References 27 publications

Prediction model of success for external cephalic version. Complications and perinatal outcomes after a successful version

Prediction model of success for external cephalic version. Complications and perinatal outcomes after a successful version

Revisiting the management of term breech presentation: a proposal for overcoming some of the controversies

Influence of the external cephalic version attempt on the Cesarean section rate: experience of a type 3 maternity hospital in France

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