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Is external cephalic version at term contraindicated in previous caesarean section? A prospective comparative cohort study
Author(s) -
Burgos J,
Cobos P,
Rodríguez L,
Osuna C,
Centeno MM,
MartínezAstorquiza T,
FernándezLlebrez L
Publication year - 2014
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.12487
Subject(s) - caesarean section , medicine , external cephalic version , obstetrics , prospective cohort study , vaginal delivery , breech presentation , uterine rupture , population , cohort study , cephalic presentation , cohort , pregnancy , gynecology , surgery , uterus , genetics , environmental health , biology
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.