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Single‐institute experience, management, success rate, and outcome after external cephalic version at term
Author(s) -
Bogner Gerhard,
Xu Fang,
Simbrunner Christian,
Bacherer Alfred,
Reisenberger Klaus
Publication year - 2012
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 - 10.1016/j.ijgo.2011.09.027
Subject(s) - medicine , external cephalic version , confidence interval , gestational age , obstetrics , logistic regression , pregnancy , retrospective cohort study , univariate analysis , multivariate analysis , surgery , breech presentation , biology , genetics
Objective To determine obstetric outcomes after external cephalic version (ECV) performed at term. Methods In a retrospective study of ECV among pregnant women at term at Klinikum Kreuzschwestern Wels between January 1999 and June 2010, univariate and multivariate logistic regression was used to analyze factors influencing success rate. Results Among 379 ECV attempts, 49.1% (95% confidence interval, 44.1–54.1) were successful. Success rate was dependent on parity, gestational age, and performing physician. Increasing parity was associated with increasing success rate ( P = 0.05). Gestational age had no influence until week 39, after which the success rate increased (success after completion of week 35, 48.1%; week 37, 43.7%; week 38, 43.5%; week 39, 64.9%; week 40 or more, 90.9%; P = 0.19). The performing physician had a significant influence ( P < 0.0005). Regarding obstetric outcome, spontaneous re‐version occurred in 8.1% of women, 81.1% of women delivered vaginally, 7.9% had unplanned cesarean delivery, and 4.9% had vacuum extraction. No harm to fetal or maternal health resulted from ECV. Conclusion ECV was found to be a safe procedure at term. The skill of the physician significantly affected the success rate. The rate of surgical delivery after successful ECV was low. A trial of ECV at term and beyond is feasible.