External cephalic version can safely be performed with most breech presentations.

Most breech babies at term are now delivered by caesarean section. Although external cephalic version reduces the number of term breech presentations, its uptake has not been as wide as is recommended by professional bodies. This may be because of fears over safety. Pooled safety data do exist, largely from case series. However, the possibility of reporting and publication biases in such studies maybe preventing both women and obstetricians from being adequately reassured. In this series of 805 consecutive version attempts, we report an extremely low complication rate and 0.5% risk of emergency caesarean section after the procedure.

(BJOG. 2019;126:493–499) Breech presentation has been managed in part by planned cesarean section, contributing to rising cesarean section rates. External cephalic version (ECV) has been used to avoid noncephalic birth and cesarean delivery and reduce complications, including uterine scarring. Although there have been large studies documenting successful and safe ECV, these studies have left out information regarding patients with a breech presentation who did not receive ECV. This study documented the outcomes of pregnancies, both low-risk and high-risk, with a breech presentation who were referred for ECV.