External cephalic version as a primary option in the management of uncomplicated singleton term breech pregnancy: is it worthwhile?

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Date
2002-05
Authors
Sachlin, Mimin Tarmini
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Universiti Sains Malaysia
Abstract
The mode of delivery for breech presentation is controversial. ECV as one of the alternatives has support of good quality evidence; despite that it does not seem to have been taken into routine clinical practice in our hospital To determine the outcome of external cephalic version, to evaluate the factors affecting the results of External Cephalic Version and to evaluate the delivery outcome of patients who had undergone External Cephalic Version. There were 278 cases studied, 240 cases without ECV and 3 8 cases undergone ECV. Between these two groups there are no significant difference in terms of Apgar Score at 5 minutes and need of NICU admission. The overall success rate of ECV is 60.5%; whereas for primigravida is 44% and multigravida is 65%. Location of fetal back at the maternal left is associated with significant higher successful version rate compared to fetal back at maternal right (P = 0.002) , anterior placenta has significant lower rate for successful version (p = 0.029) however there are no significant differences in terms of operator of ECV, type of breech, body mass index and use of tocolysis. Out of 23 cases who had successful version, 20 cases (87%) delivered SVD and 3 cases (13%) needed LSCS. ECV is an accepted procedure and should be considered in an uncomplicated singleton term breech pregnancy. The success rate ofECV is 60.5%. The factors that have a significant prognostic predictive value are placental location and position of the fetal spine towards maternal spine. Successful version significantly increases the chance of the patients to have a vertex vaginal delivery. There were no difference in term of perinatal outcome betweeh patients who undergone ECV and no ECV.
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External Cephalic Version (ECV)
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