Is external cephalic version at term contraindicated in previous caesarean section? A prospective comparative cohort study

Objective To determine if external cephalic version ( ECV ) can be performed with safety and efficacy in women with previous caesarean section. Design Prospective comparative cohort study. Setting Cruces U niversity H ospital ( S pain). Population Single pregnancy with breech presentation at term. Methods We compared 70  ECV performed in women with previous caesarean section with 387  ECV performed in multiparous women ( M arch 2002 to J une 2012). Main outcome measures Success rate, complications of the ECV and caesarean section rate. Results The success rate of ECV in women after previous caesarean section was 67.1% versus 66.1% in multiparous women ( P  = 0.87). The logistic regression analysis confirmed this result (odds ratio 0.93, 95% CI 0.52–1.68; P  = 0.82) adjusted by the variables associated with success of ECV . There were no complications in the previous caesarean section cohort. The vaginal delivery rate in the previous caesarean section cohort was 52.8% versus 74.9% in the multiparous cohort ( P  < 0.01). There were no cases of uterine rupture. Conclusion Based on our data, we conclude that complications are uncommon with ECV in women with previous caesarean section, with a success rate comparable to that of multiparous women. Uterine scar should not be considered a contraindication and ECV should be offered to women with previous caesarean section with breech presentation at term.