Does fetal weight estimated by ultrasound really affect the success rate of external cephalic version?

Abstract

OBJECTIVE. To determine whether fetal weight estimated by ultrasound on the day the external cephalic version (ECV) is related to the procedure's success rate. DESIGN. Retrospective cohort study. Setting. University hospital. POPULATION OR SAMPLE. Two hundred women with a singleton pregnancy undergoing an ECV attempt between March 2002 and March 2006. METHOD. Projected birthweight at delivery was calculated. Logistic regression analysis, by grams and by weight intervals, and multiple correspondence analysis were performed to determine whether or not the weight was related to the procedure's success. Specific statistical analysis was undertaken to minimize measurement bias in fetal weight estimation. MAIN OUTCOME MEASURE. Success of ECV in relation to estimated fetal weight. RESULTS. Measurement bias was ruled out because no statistically significant differences were identified with the Student's t-test (p>0.05), Bland-Altman's agreement analysis, and the interclass correlation coefficient analysis (ICC = 0.829; CI95% 0.772-0.871; p<0.01). By logistic regression analysis, a variable relation between fetal weight estimated by ultrasound and ECV success was detected, while multiple correspondence analysis suggested that variations in fetal weight are weakly related to the procedure's success or failure. No relation was identified between ECV and birthweight (p = 0.38) when the delivery took place in the same week as the version. CONCLUSIONS. Estimated fetal weight before ECV seems not to be related to the outcome of ECV.

A prospective study of the factors associated with the success rate of external cephalic version for breech presentation at term

“…Table 3 summarizes the results of previous studies [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20], and shows the wide inter-study variability. Other factors might affect the success rate of ECV, but are more difficult to measure.…”

“…We consider that study of this variable, in light of its nature, requires a specific study design. Accordingly, we designed a specific study to determine its effect on the success rate of ECV, but no association was found [20].…”

“…Ferguson et al [2] 1987 + -+ + + -Fortunato et al [3] 1988 -+ + -+ --Hellstrom et al [4] 1990 + --+ + Newman et al [5] 1993 + -+ + Shalev et al [6] 1993 ---+ -+ Kainer et al [7] 1994 --+ -Ben-Arie et al [8] 1995 + -+ + Flock et al [9] 1998 + + + Aisenbrey et al [10] 1999 + + + -Ezra et al [11] 2000 + -----Ruangchainikom and Chareonporn [12] 2001 ----+ -+ Lojacono et al [13] 2003 ----Le Bret et al [14] 2004 + + + Weiniger et al [15] 2007 --+ -Rueangchainikhom et al [16] 2008 ---+ Ben-Meir et al [17] 2008 + + + + + Kok et al [18] 2008 + + -Tasnim et al [19] 2009 + + -Burgos et al [20] 2009 -Key: "+" factor affecting the success rate of ECV; "-" factor with no effect on the success rate of ECV.…”

Nitrous oxide for analgesia in external cephalic version at term: prospective comparative studya

“…All the ECVs were carried out according to the protocol used because the technique was adopted in our hospital [3,6,7]. The exclusion criteria for ECV in our center are placenta previa, placental abruption, uterine malformation, oligohydramnios, signs of fetal distress, fetal death, severe fetal malformations, multiple pregnancy, Rh incompatibility, clotting disorders, and any indications for cesarean section.…”

Prediction of Success in External Cephalic Version under Tocolysis: Still a Challenge

“…Several studies have addressed the prediction of success in ECV [6][7][8][9][10][11][12][13][14][15][16][17] with conflicting evidence. 18 Multiple predictive factors have been proposed in these studies, assessed either by clinical history and physical examination or by ultrasound.…”