External Cephalic Version—A Chance for Vaginal Delivery at Breech Presentation

External Cephalic Version—A Chance for Vaginal Delivery at Breech Presentation

Background and Objectives: In recent years, the rate of caesarean section (CS) has increased constantly. Although vaginal breech delivery has a long history, breech presentation has become the third most common indication for CS. This study aims to identify factors associated with the success of ext...

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Bibliographic Details
Published in:Medicina (Kaunas, Lithuania) Vol. 58; no. 11; p. 1619
Main Authors: Cobec, Ionut Marcel, Varzaru, Vlad Bogdan, Kövendy, Tamas, Kuban, Lorant, Eftenoiu, Anca-Elena, Moatar, Aurica Elisabeta, Rempen, Andreas
Format: Journal Article
Language:English
Published: Basel MDPI AG 01-11-2022
MDPI
Subjects:
Amniotic fluid
Breech delivery
Breech presentation
caesarean section
Cardiac arrhythmia
Cesarean section
Childbirth & labor
external cephalic version
Fetuses
Gestational age
Health aspects
Mortality
Neuromuscular diseases
Patient outcomes
Patients
Pregnancy
Pregnant women
Success
Ultrasonic imaging
Uterus
Vagina
vaginal birth
Womens health
Germany
United States > US
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Summary:Background and Objectives: In recent years, the rate of caesarean section (CS) has increased constantly. Although vaginal breech delivery has a long history, breech presentation has become the third most common indication for CS. This study aims to identify factors associated with the success of external cephalic version (ECV), underline the success rate of ECV for breech presentation and highlight the high rate of vaginal delivery after successful ECV. Material and Methods: This retrospective observational study included 113 patients with singleton fetuses in breech presentation, who underwent ECV from January 2016 to March 2021 in the Clinic of Obstetrics and Gynecology, Diakonieklinikum Schwäbisch Hall, Germany. Maternal and fetal parameters and data related to procedure and delivery were collected. Possible predictors of successful ECV were evaluated. Results: The success rate of ECV was 54.9%. The overall rate of vaginal birth was 44.2%, regardless of ECV outcome. The vaginal birth rate after successful ECV was 80.6%. Overall, 79.0% of women with successful ECV delivered spontaneously without complications, 19.4% delivered through CS performed during labor by medical necessity, and 1.6% delivered through vacuum extraction. ECV was performed successfully in three of the four women with history of CS. Gravidity, parity, maternal age, gestational age, fetal weight, and amniotic fluid index (AFI) were significantly correlated with the outcome of ECV. Conclusions: ECV for breech presentation is a safe procedure with a good success rate, thus increasing the proportion of vaginal births. Maternal and fetal parameters can be used to estimate the chances of successful ECV.
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ISSN:1648-9144
1010-660X
1648-9144
DOI:10.3390/medicina58111619