To determine the rate of success of external cephalic version in low risk breech presentations and possible factors affecting its success in POF hospital, Wah Cantt.

Majeed, Noreen; Kalsoom, Shabana; Safdar, Faiza; Rafique, Shazia; Tariq, Shamsa; Bibi, Saana

doi:10.37939/jrmc.v25i2.1507

“…Cochrane Central and clinicaltrials.gov provided only a few additional records. During citation searching, we found further potentially relevant articles(e.g., 53 . We later realized that they could be found in Google Scholar, but none of those other databases, likely because they were published in lesser-known international journals.…”

Section: Consent For Publicationmentioning

confidence: 99%

Prediction Models for Successful External Cephalic Version: An Updated Systematic Review

Yerrabelli,

Lee,

Palsgaard

et al. 2023

Am J Perinatol

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PURPOSE: To review the decision aids currently available or being developed to predict a patient’s odds that their external cephalic version (ECV) will be successful. METHODS: We searched PubMed/MEDLINE, Cochrane Central, and ClinicalTrials.gov from 2015-2022. Articles from a pre-2015 systematic review were also included. We selected English-language articles describing or evaluating models (prediction rules) designed to predict an outcome of ECV for an individual patient. Acceptable model outcomes included cephalic presentation after the ECV attempt and whether the ECV ultimately resulted in a vaginal delivery. Two authors independently performed article selection following PRISMA 2020 guidelines. Since 2015, 380 unique records underwent title and abstract screening, and 49 reports underwent full-text review. Ultimately, 17 new articles and 8 from the prior review were included. Of the 25 articles, 22 proposed 1-2 models each for a total of 25 models, while the remaining 3 articles validated prior models without proposing new ones. RESULTS: Of the 17 new articles, 10 were low, 6 moderate, and 1 high risk of bias. Almost all articles were from Europe (11/25) or Asia (10/25); only one study in the last 20 years was from the USA. The models found had diverse presentations including score charts, decision trees (flowcharts), and equations. The majority (13/25) had no form of validation and only 5/25 reached external validation. Only the Newman-Peacock model (USA, 1993) was repeatedly externally validated (Pakistan, 2012 and Portugal, 2018). Most models (14/25) were published in the last 5 years. In general, newer models were designed more robustly, used larger sample sizes, and were more mathematically rigorous. Thus, although they await further validation, there is great potential for these models to be more predictive than the Newman-Peacock model. CONCLUSION: Only the Newman-Peacock model is ready for regular clinical use. Many newer models are promising but require further validation.

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“…8 In our recently published study, we found multiparity unengaged breech & complete flexed breech as predictors of successful ECV, and the success rate of ECV was 48.2% in the study. 9 There are few contraindications for ECV, like placenta previa, placental abruption, abnormal CTG/doppler, severe preclampsia & conditions where the indication for caesarean section is already present. The complication rate of ECV procedure is very low, only a 0.5% rate of emergency caesarean within 24 hrs is narrated due to abnormal CTG or vaginal bleeding.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Materials used in Facilitating External Cephalic Version

Majeed¹,

Safdar²,

Nisa³

et al. 2022

JRMC

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Introduction: External cephalic version (ECV) is a procedure to manipulate a fetus with breech presentation to cephalic presentation through maternal abdomen under ultrasound guidance. It is done to reduce the number of assisted breech deliveries and caesarean sections for breech presentation. Talcum powder or aqueous gel is frequently used to facilitate ECV. We compared powder with gel in attaining a successful version and level of practitioner satisfaction with powder versus gel use.Materials and Methods: This retrospective descriptive study was conducted by Wah Medical College in POF hospital (affiliated with WMC) , Wah Cantt from 10th Oct 2015- 10th Oct 2019. Total of 56 low risk gravid women underwent ECV after selection on the basis of inclusion and exclusion criteria. By using convenient consecutive sampling, powder or gel during ECV was allocated accordingly. ECV was performed by the single experienced practitioner in labour room with cardiotocograph and emergency caesarean facilities . Powder and gel use was compared in attaining a successful version. ECV was declared successful on confirming head of fetus in lower uterine segment on ultrasound. Unsuccessful ECVs were reattempted with crossover use to the other aid. Practitioner satisfaction was defined as, ease experienced by the practitioner in performing ECV. It was graded as high, medium and low on the base of ease or difficulty experienced by the practitioner while using powder or gel during ECV. The data was recorded & analysed using SPSS software. Descriptive statistics with Chi-square test is applied to find out the association between successful version & practitioner satisfaction level with powder versus gel use.Results: In the powder use group, 9 ECVs were successful and 19 ECV’s were unsuccessful. In gel use group, 12 ECVs were successful and 16 were unsuccessful. There were more successful ECV’s in gel group but the association was not significant (P-value .408). Practitioner satisfaction was significantly high with gel than the powder use(P-value .<.001).Conclusion: Powder or gel is not superior over the other as an aid for achieving successful ECV though gel use is more satisfying for the provider than powder use in performing ECV. More studies are required regarding aids used in performing ECV for recommendations in clinical practice.

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Prediction Models for Successful External Cephalic Version: An Updated Systematic Review

Yerrabelli

¹

,

Lee

²

,

Palsgaard

³

et al. 2023

Preprint

0

View full text Add to dashboard Cite

PURPOSE: To review the decision aids currently available or being developed to predict a patient’s odds that their external cephalic version (ECV) will be successful. METHODS: We searched PubMed/MEDLINE, Cochrane Central, and ClinicalTrials.gov from 2015-2022. Articles from a pre-2015 systematic review were also included. We selected English-language articles describing or evaluating models (prediction rules) designed to predict an outcome of ECV for an individual patient. Acceptable model outcomes included cephalic presentation after the ECV attempt and whether the ECV ultimately resulted in a vaginal delivery. Two authors independently performed article selection following PRISMA 2020 guidelines. Since 2015, 380 unique records underwent title and abstract screening, and 49 reports underwent full-text review. Ultimately, 17 new articles and 8 from the prior review were included. Of the 25 articles, 22 proposed 1-2 models each for a total of 25 models, while the remaining 3 articles validated prior models without proposing new ones. RESULTS: Of the 17 new articles, 10 were low, 6 moderate, and 1 high risk of bias. Almost all articles were from Europe (11/25) or Asia (10/25); only one study in the last 20 years was from the USA. The models found had diverse presentations including score charts, decision trees (flowcharts), and equations. The majority (13/25) had no form of validation and only 5/25 reached external validation. Only the Newman-Peacock model (USA, 1993) was repeatedly externally validated (Pakistan, 2012 and Portugal, 2018). Most models (14/25) were published in the last 5 years. In general, newer models were designed more robustly, used larger sample sizes, and were more mathematically rigorous. Thus, although they await further validation, there is great potential for these models to be more predictive than the Newman-Peacock model. CONCLUSION: Only the Newman-Peacock model is ready for regular clinical use. Many newer models are promising but require further validation.

show abstract

To determine the rate of success of external cephalic version in low risk breech presentations and possible factors affecting its success in POF hospital, Wah Cantt.

Cited by 4 publications

References 15 publications

Prediction Models for Successful External Cephalic Version: An Updated Systematic Review

Prediction Models for Successful External Cephalic Version: An Updated Systematic Review

Comparison of Materials used in Facilitating External Cephalic Version

Prediction Models for Successful External Cephalic Version: An Updated Systematic Review

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