Comparison of Fetomaternal Outcome between 47 Deliveries Following Successful External Cephalic Version for Breech Presentation and 7456 Deliveries Following Spontaneous Cephalic Presentation

Background: Achieving a cephalic position after a successful external cephalic version (ECV) is desired to result in delivery and fetal outcomes that are similar to those of deliveries following spontaneous cephalic presentation. Methods: We performed a retrospective cohort study including patients with successful ECV following fetal breech position (ECV cohort, n = 47) or with a singleton spontaneous cephalic pregnancy at ≥37 weeks of gestational age (control group, n = 7,456) attempting a vaginal delivery between 2010 and 2013 at the University Hospital Ulm. The mode of delivery and fetal outcome parameters were compared between these 2 groups using nonparametric statistics. Results: ECV cohort and control group did not differ with respect to maternal age, parity, gestational age at birth, and fetal gender. There were no significant differences between the 2 groups with regard to all parameters indicating fetal outcome. However, the rate of cesarean sections was higher after successful ECV compared to spontaneous cephalic presentation (27.7 vs. 12.8%, OR 2.615). Conclusion: While vaginal delivery is less likely to happen after a successful ECV compared to spontaneous cephalic singleton pregnancies, fetal outcome parameters showed no difference between the 2 groups. Physicians should be counseling and encouraging women to attempt ECV, as it is a safe and effective procedure.

[1]  Practice Bulletin No. 161: External Cephalic Version , 2016, Obstetrics and gynecology.

[2]  F. Ebner,et al.  Predictors for a successful external cephalic version: a single centre experience , 2016, Archives of Gynecology and Obstetrics.

[3]  M. Hannah,et al.  Planned caesarean section for term breech delivery. , 2015, The Cochrane database of systematic reviews.

[4]  B. Carvalho,et al.  The dilemma of vaginal breech delivery worldwide , 2014, The Lancet.

[5]  B. Mol,et al.  Mode of Delivery After Successful External Cephalic Version: A Systematic Review and Meta-analysis , 2014, Obstetrics and gynecology.

[6]  M. Shafiee,et al.  Successful External Cephalic Version: Factors Predicting Vaginal Birth , 2014, TheScientificWorldJournal.

[7]  V. Pop,et al.  Mode of delivery following successful external cephalic version: comparison with spontaneous cephalic presentations at delivery. , 2013, Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC.

[8]  J. Chung,et al.  Cesarean risk after successful external cephalic version: a matched, retrospective analysis , 2009, Journal of Perinatology.

[9]  M. Voigt,et al.  Sex-specific differences in birth weight due to maternal smoking during pregnancy , 2006, European Journal of Pediatrics.

[10]  J. L. Tang,et al.  Intrapartum Cesarean Delivery After Successful External Cephalic Version: A Meta-Analysis , 2004, Obstetrics and gynecology.

[11]  M. Boucher,et al.  Cesarean delivery after successful external cephalic version of breech presentation at term: a comparative study. , 2004, American journal of obstetrics and gynecology.

[12]  E. Hodnett,et al.  Outcomes at 3 months after planned cesarean vs planned vaginal delivery for breech presentation at term: the international randomized Term Breech Trial. , 2002, JAMA.

[13]  Andrew R Willan,et al.  Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial , 2000, The Lancet.

[14]  G. Hofmeyr,et al.  External cephalic version for breech presentation at term. , 2000, The Cochrane database of systematic reviews.

[15]  D. Rouse,et al.  Reductions in cost and cesarean rate by routine use of external cephalic version: a decision analysis. , 1995, Obstetrics and gynecology.

[16]  J. Daling,et al.  The frequency of breech presentation by gestational age at birth: a large population-based study. , 1992, American journal of obstetrics and gynecology.