The implementation of external cephalic version at term for singleton breech presentation--how can we further increase its impact?

The Australian & New Zealand Journal of Obstetrics & Gynaecology
T K LauM S Rogers

Abstract

The overall incidence of breech presentation at delivery remained at 2 to 3% in a unit where external cephalic version (ECV) was the preferred treatment option for term singleton breech presentation. The objective of this study was to investigate which factors accounted for this high residual incidence, so that the impact of ECV could be further increased. All breech deliveries and ECVs over a 1-year period in a teaching hospital are reviewed. The incidence of term singleton breech delivery was 1.96% among 7,702 total deliveries. There were 115 patients counselled for ECV, of which 15.7% declined the offer and 4.1% went into labour before their scheduled ECV. Among the 93 ECVs performed, 74 were successful and 56 delivered vaginally in cephalic presentation. ECV was not performed in 131 cases. The major reasons were patients' refusal (13.7%), breech first diagnosed in labour or after rupture of membranes (44.3%), oligohydramnios or growth retardation (9.9%) and previous Caesarean section (8.4%). Only 5 patients were not counselled for ECV in the absence of contraindications. The practice of ECV reduced the overall Caesarean section rate by 0.65%, or 4.3% of the total number of Caesarean sections. In conclusion, ECV at term defi...Continue Reading

References

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Citations

May 16, 2000·Obstetrics and Gynecology·B C BrostM Hester
Nov 7, 2000·The Australian & New Zealand Journal of Obstetrics & Gynaecology·T Y LeungM S Rogers
Nov 3, 2005·Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology·D SiassakosK Panter
Dec 31, 2008·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·M KokB W Mol
Feb 10, 2006·Paediatric and Perinatal Epidemiology·Natasha NassarBrian Peat
Nov 4, 2008·Obstetrics and Gynecology·Kim GrootscholtenJoris A van der Post

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