TITLE:
External Cephalic Version: A Single Centre Experience
AUTHORS:
Kassam Mahomed, Poornima Amaranarayana, Ibinabo Ibiebele
KEYWORDS:
ECV; Breech; Labour; Caesarean; Predictors
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.4 No.6,
April
15,
2014
ABSTRACT:
Incidence of caesarean
section for breech presentation has increased markedly. External cephalic
version (ECV) is effective in reducing non cephalic presentation at births and
caesarean section (CS) for breech presentation. Success rates are good but
there is increasing need for induction of labour (IOL) as well as for
intrapartum CS for reasons that are not clear. The aim of this study was to
report the experience with ECV at a single centre where ECVs were performed by
or under the guidance of one senior clinician. This was a 7-year retrospective
audit of 147 ECVs at a single centre in Queensland. ECV was successful in
53.7%, 34% in nulliparous and 69% in multiparous women. Of the few variables
explored, nulliparity was the only variable that was associated with poor
success. Among those with successful ECV, 32 (40.5%) had IOL. Intrapartum CS
rate in women who had had a successful ECV was 16.5% compared to 11% for the
hospital. There was no difference in early neonatal outcome between the groups.
We have confirmed a success rate that is comparable with many other studies.
Mothers with successful ECV do have a higher IOL and a higher CS rate
especially in women whose labour is induced. We suggest a need to look at some
novel methods to increase uptake further and to improve success rates in
nulliparous women.