Outcome of external cephalic version after 36 weeks' gestation without tocolysis
✍ Scribed by Lawrence Impey; Donatella Lissoni
- Publisher
- John Wiley and Sons
- Year
- 1999
- Tongue
- English
- Weight
- 48 KB
- Volume
- 8
- Category
- Article
- ISSN
- 1057-0802
No coin nor oath required. For personal study only.
✦ Synopsis
Objective: Despite its efficacy, external cephalic version (ECV) at term is not universally employed. Published series of Caucasian women are small and concerns regarding safety and spontaneous version remain. We review the outcomes of 26 months of a breech clinic in a Dublin teaching hospital. Methods: All women with known breech presentation at 36ϩ weeks were referred unless another indication for cesarean section existed. Unstable lie, fetal compromise, antepartum hemorrhage, and patient refusal were the only contraindications to ECV. One operator attempted all versions, without tocolysis. Results: Three hundred seventy women were referred and in 356 (95%), version was attempted at a mean gestation of 37 ϩ 3 weeks; 195 (55%) were nulliparous and 161 (45%) were multiparous. The success rate was 43%, including 33% of nulliparous and 54% of multiparous women. There were three perinatal deaths (0.8%), all unrelated to the version. Minor complications were rare, although two women were delivered by cesarean section shortly after unsuccessful version. Ninety-three percent of successful versions were cephalic at delivery, as were 4% of unsuccessful versions; 12% of infants with a cephalic presentation after successful version were delivered by cesarean section. Conclusions: