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An observational study of the success and complications of 2546 external cephalic versions in low‐risk pregnant women performed by trained midwives
Author(s) -
Beuckens A,
Rijnders M,
VerburgtDoeleman GHM,
Rijninksvan Driel GC,
Thorpe J,
Hutton EK
Publication year - 2016
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 - 10.1111/1471-0528.13234
Subject(s) - medicine , external cephalic version , cephalic presentation , obstetrics , observational study , pregnancy , breech presentation , gestation , population , caesarean section , gestational age , gynecology , genetics , environmental health , pathology , biology
Objective To evaluate the success of an external cephalic version ( ECV ) training programme, and to determine the rates of successful ECV , complications, and caesarean birth in a low‐risk population. Design Prospective observational study. Setting Primary health care and hospital settings throughout the Netherlands (January 2008–September 2011). Population Low‐risk women with a singleton fetus in breech presentation, without contraindications to ECV , were offered ECV at approximately 36 weeks of gestation. Methods Data were collected for all ECV s performed by midwives, and were entered into a national online database. Main measures Successful ECV was defined as the fetus having a cephalic presentation immediately following the procedure and at birth. Complications were observed at ≤30 minutes and between 30 minutes and 48 hours after the ECV procedure. All serious pregnancy outcomes that occurred after the ECV procedure until birth were reported. Results A total of 47% had a successful ECv and a cephalic at the time of birth: 34% of nulliparous and 66% of multiparous women. After ECV , 57% of women gave birth vaginally: 45% of nulliparous women and 76% of multiparous women. Within 30 minutes after ECV , and between 30 minutes and 48 hours after ECV , the proportion of women experiencing a complication or serious pregnancy outcome was 0.9% and 1.8%, respectively. Serious pregnancy outcome at any time following ECV until birth was experienced by 58 (2.5%) of the women. Conclusions The success rate of ECV s performed by trained midwives in primary health care or hospital settings is comparable with that of other providers, and the procedure is safe for low‐risk women.