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 present...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.展开更多
文摘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.
