Routine Use of External Cephalic Version in Three Hospitals

Abstract

External cephalic version is effective in reducing the number of cesarean deliveries in term breech infants in different obstetric settings, with no major neonatal adverse outcomes.

Matched cohort study of external cephalic version in women with previous cesarean delivery

“…Previously reported complications associated with ECV in women with prior cesarean delivery include transient fetal heart abnormalities, vaginal bleeding, and the need for emergency cesarean delivery. [7][8][9][10][11][12][13] No cases of uterine rupture have been reported to date, but in the present study, two women had scar dehiscence, which was noted during cesarean delivery performed for fetal distress in labor. These incidents of scar dehiscence could be related to factors during labor rather than ECV, because scar dehiscence occurred 10 days after the performance of ECV.…”

“…This results in a reduced threshold indicating cesarean delivery leading to an increase in emergency cesarean rates. Since 1991, when Flamm et al 6 reported a success rate of 82% for ECV in 56 women with a previous cesarean delivery, with no serious complications to the mother and fetus, seven observational studies [7][8][9][10][11][12][13] have been conducted ( Table 4). The pooled data from these studies [6][7][8][9][10][11][12][13] including 430 women with previous cesarean delivery who underwent ECV indicate an overall success rate of 76% (n=327) and no major complications to the mother and infant.…”

“…Although a previous cesarean delivery is considered a relative contraindication for ECV, a few observational studies have reported the safety and efficacy of ECV in this setting. [6][7][8][9][10][11][12][13] The present study was conducted to evaluate the safety and efficacy of ECV among women with prior cesarean delivery with breech presentation at term.…”

External cephalic version: a safe procedure? A systematic review of version‐related risks

“…These often concern unusual and rare complications. Such a complication is the version-related femur fracture in one of the analyzed studies (25). Another reported case relates to a cervical spinal cord transection possibly caused by a version procedure (93).…”

Complications of external cephalic version: a retrospective analysis of 1121 patients at a tertiary hospital in Sydney

“…While the overall complication rate associated with ECV is low, [3][4][5][6][7] ECV is not without potential complications, which range from relatively minor events such as transient changes in fetal heart-rate patterns or ruptured membranes, through to rare but serious adverse outcomes including placental abruption and feto-maternal transfusion, [3][4][5][6][7][8][9][10][11] fetal distress requiring emergency caesarean section, [3][4][5][6] cord prolapse, 5,6 fracture of fetal bones, 5,12 and fetal death. 4,[13][14][15] Case reports of uterine torsion with associated fetal bradycardia, 16 fetal recto-vaginal tear requiring colostomy 17 and a fetal spinal cord transection believed to be secondary to a successful ECV exist.…”