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Success rates of early versus late initiation of external cephalic version
Author(s) -
Lavie Anat,
Reicher Lee,
Avraham Sarit,
Ram Maya,
Maslovitz Sharon
Publication year - 2019
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12774
Subject(s) - external cephalic version , medicine , breech presentation , cephalic presentation , presentation (obstetrics) , cesarean delivery , incidence (geometry) , retrospective cohort study , obstetrics , vaginal delivery , gynecology , pregnancy , surgery , genetics , physics , optics , biology
Objective To determine optimum timing of external cephalic version ( ECV ). Methods A retrospective cohort study was conducted at a tertiary hospital in Israel between February 1, 2016, and July 1, 2017. Healthy primiparous women with breech presentation were offered either early ECV (35–36 weeks; n=54) or late ECV (37–38 weeks; n=106). Group assignment was according to the patient's preference and physician availability. The primary outcome was the rate of cephalic presentation at delivery. Secondary outcomes included rate of cesarean delivery, presentation of fetus after the first and last ECV s, and serious fetal complications. Results The incidence of undergoing more than two ECV attempts was 18.5% in the early ECV group and 5.6% in the late ECV group ( P =0.039). The incidence of cephalic presentation after the first ECV was 72.2% in the early ECV group versus 66.0% in the late ECV group ( P =0.048). By contrast, no statistically significant between‐group differences were found for presentation at delivery or rate of cesarean delivery. The other outcomes were also similar. Conclusion Early initiation of ECV among primiparous women increased the chance of immediate cephalic presentation; however, it had no effect on presentation at delivery or cesarean delivery rate.