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Published online: 2024-04-26

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External cephalic version — single-center experience

Maciej Kwiatek1, Tomasz Geca1, Aleksandra Stupak1, Wojciech Kwasniewski2, Radoslaw Mlak3, Anna Kwasniewska1


Objectives: External cephalic version (ECV) is an alternative to caesarean section for abnormal fetal position. ECV is recommended by the most important scientific committees in the world. ECV complications are rare and occur in 6.1% of cases, however severe complications requiring urgent caesarean section are found in less than 0.4%. Our aim was to demonstrate the effectiveness and safety of ECV and to present our own experience with the procedure of ECV.

Material and methods: ECV was performed on 62 patients (32 nulliparas and 30 multiparas). Qualification criteria included: singleton gestation, gestational age > 36 + 6, longitudinal pelvic lie, no uterine contractions, intact membranes. Indications for immediate cesarean section within 24 hours of ECV were considered a procedural complication. In patients with complications, the condition of the newborn was checked according to the APGAR score and the day of discharge of the mother and child from the maternity ward was analyzed.

Results: ECV finished successfully in 66.1% (nulliparas 56.2% and multiparas 76.7%). Patients with a successful ECV were significantly older and had higher median gestational age. ECV was more often successful when placenta was located on the posteriori wall. In our patients, there were 4 cases of complications requiring delivery at the time of ECV. No serious consequences associated with increased maternal or neonatal morbidity or mortality were reported.

Conclusions: ECV seems to be a safe alternative for women wishing to deliver vaginally, as this procedure does not increase the risk of adverse obstetric outcomes.

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  1. Słomko Z. Ginekologia T. 1. Wydawnictwo Lekarskie PZWL, Warszawa 2008.
  2. Tsakiridis I, Mamopoulos A, Athanasiadis A, et al. Management of Breech Presentation: A Comparison of Four National Evidence-Based Guidelines. Am J Perinatol. 2020; 37(11): 1102–1109.
  3. World Health Organization Human Reproduction Programme, 10 April 2015. WHO Statement on caesarean section rates. Reprod Health Matters. 2015; 23(45): 149–150.
  4. Xie RH, Gaudet L, Krewski D, et al. Higher cesarean delivery rates are associated with higher infant mortality rates in industrialized countries. Birth. 2015; 42(1): 62–69.
  5. Hofmeyr GJ, Kulier R, West HM, et al. External cephalic version for breech presentation at term. Cochrane Database Syst Rev. 2000; 10(2): CD000083.
  6. External Cephalic Version and Reducing the Incidence of Term Breech Presentation: Green-top Guideline No. 20a. BJOG. 2017; 124(7): e178–e192.
  7. Management of Breech Presentation: Green-top Guideline No. 20b. BJOG. 2017; 124(7): e151–e177.
  8. ACOG Committee Opinion No. 745: Mode of Term Singleton Breech Delivery. Obstet Gynecol. 2018; 132(2): e60–e63.
  9. American College of Obstetricians and Gynecologists' Committee on Practice Bulletins--Obstetrics, American College of Obstetricians and Gynecologists' Committee on Practice Bulletins--Obstetrics. Practice Bulletin No. 161 Summary: External Cephalic Version. Obstet Gynecol. 2016; 127(2): 412–413.
  10. Kotaska A, Menticoglou S, Gagnon R, et al. Society of Obstetricians and Gynaecologists of Canada, MATERNAL FETAL MEDICINE COMMITTEE. Vaginal delivery of breech presentation. J Obstet Gynaecol Can. 2009; 31(6): 557–566.
  11. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Management of breech presentation at term. (28.05.2019).
  12. Wielgos M, Bomba-Opoń D, Breborowicz GH, et al. Recommendations of the Polish Society of Gynecologists and Obstetricians regarding caesarean sections. Ginekol Pol. 2018; 89(11): 644–657.
  13. Bewley S, Robson SC, Smith M, et al. The introduction of external cephalic version at term into routine clinical practice. Eur J Obstet Gynecol Reprod Biol. 1993; 52(2): 89–93.
  14. Yogev Y, Horowitz E, Ben-Haroush A, et al. Changing attitudes toward mode of delivery and external cephalic version in breech presentations. Int J Gynaecol Obstet. 2002; 79(3): 221–224.
  15. Leung TY, Lau TK, Lo KW, et al. A survey of pregnant women's attitude towards breech delivery and external cephalic version. Aust N Z J Obstet Gynaecol. 2000; 40(3): 253–259.
  16. Raynes-Greenow CH, Roberts CL, Barratt A, et al. Pregnant women's preferences and knowledge of term breech management, in an Australian setting. Midwifery. 2004; 20(2): 181–187.
  17. Cluver C, Gyte GML, Sinclair M, et al. Interventions for helping to turn term breech babies to head first presentation when using external cephalic version. Cochrane Database Syst Rev. 2012; 1(2): CD000184.
  18. What factors determine the success of an external cephalic version? BJOG. 2019; 126(4): 501.
  19. Grootscholten K, Kok M, Oei SG, et al. External cephalic version-related risks: a meta-analysis. Obstet Gynecol. 2008; 112(5): 1143–1151.
  20. Ben-Meir A, Elram T, Tsafrir A, et al. The incidence of spontaneous version after failed external cephalic version. Am J Obstet Gynecol. 2007; 196(2): 157.e1–157.e3.
  21. Katukuri V, Andrews S, Leeman L, et al. What Happens after a Failed External Cephalic Version? [36I]. Obstetrics & Gynecology. 2018; 131(1).