External cephalic version for breech presentation at term. A prospective interventional study

OBJECTIVES: To evaluate the external cephalic version (ECV) procedure for the management of at term breech presenting fetuses.

METHODS: In this prospective, interventional study, 90 patients with uncomplicated breech presentations at or after 37 weeks’ gestation were considered for ECV. This was performed in Al-Batool Teaching Hospital, Mosul, Iraq, between January 2011 and March 2012. The main outcome measure was assessed as the success rate of ECV attempt and the rate of cesarean section following a successful procedure. Parity, type of breech, placental location, and birth weight were evaluated as predictors of success. Also, any fetal or maternal complications during the procedure were evaluated. Data were analyzed by x2 test. Statistical significance was determined at a level of p<0.05.

RESULTS: The success rate was 80%. The rate of cesarean section following successful procedure was only 12.5%. Prognostic parameters associated with successful ECV were multiparity and flexed type of breech. There were no serious fetal or maternal complications associated with the attempt. Conclusions: With appropriate selection of patients, ECV is highly successful and is a safer alternative to vaginal breech delivery or cesarean delivery.