scholarly journals External cephalic version for breech presentation at term: predictors of success, and impact on the rate of caesarean section

2013 ◽  
Vol 19 (02) ◽  
pp. 162-166 ◽  
Author(s):  
O.A. Hussin ◽  
M.A. Mahmoud ◽  
M.M. Abdel Fattah
Keyword(s):  
Caesarean Section ◽  
Breech Presentation ◽  
External Cephalic Version ◽  
Predictors Of Success

External Cephalic Version at Term with Tocolysis

1988 ◽  
Vol 18 (3) ◽  
pp. 119-124 ◽  
Author(s):  
G Justus Hofmeyr
Keyword(s):  
Developing Countries ◽  
Caesarean Section ◽  
Breech Presentation ◽  
External Cephalic Version ◽  
Cephalopelvic Disproportion ◽  
Breech Delivery ◽  
Vaginal Breech Delivery ◽  
High Prevalence ◽  
Large Families ◽  
Tocolytic Agents

The problems associated with breech presentation are of particular importance in developing countries. The risk of vaginal breech delivery may be increased because of a high prevalence of cephalopelvic disproportion. Caesarean section presents specific risks to women who may not have medical care in subsequent pregnancies and may desire large families. External cephalic version (ECV) before term has not been proved conclusively to influence the outcome of pregnancy. ECV performed at term (37 or more weeks gestation), using tocolytic agents to relax the uterus, has been shown in a technologically developed setting to reduce the incidence of breech presentation and of Caesarean section. The application of this procedure when technological facilities are limited is discussed and the technique is described.

scholarly journals External cephalic version at 36 weeks and its outcome

2017 ◽  
Vol 6 (10) ◽  
pp. 4602
Author(s):  
Deepika N. ◽  
Arun Kumar
Keyword(s):  
Caesarean Section ◽  
Success Rate ◽  
Caesarean Section Rate ◽  
Invasive Procedure ◽  
Breech Presentation ◽  
External Cephalic Version ◽  
Clinical Settings ◽  
Safe Procedure ◽  
Breech Delivery ◽  
Non Invasive

Background: External cephalic version (ECV) is well known non-invasive procedure done for the management of breech presentation but is not routinely practised by obstetricians in many clinical settings. The aim of the study was to assess the success rate of external cephalic version, labour outcome of pregnancy after successful ECV, to study maternal and foetal complications associated with ECV and to explore the reasons for failed ECV.Methods: It was a prospective interventional study to assess the labour outcomes of pregnancies with successful and uncomplicated ECV. All women who had singleton breech presentation at 36+ weeks were included unless contraindications for ECV were present. After obtaining consent, ECV was attempted after giving tocolysis.Results: The total number of deliveries was 6038 in the same period. Out of these 301 were breech presentations thus the incidence of breech presentation was 4.9%. ECV was offered to 81 women (26.9%) and out of these 77 women (95.06%) gave consent for the procedure. The remaining 4 (4.93%) did not give consent due to anxiety about the procedure. The success rate was 54.54%. Out of total 301 women with breech presentation 40 women (13.3%) had assisted breech delivery and 216 women (71.8%) had caesarean section due to obstetric indications. Thus the caesarean section rate for breech presentation at our institute was 71.8%. ECV was successful in 63.82% of the multigravida on which it was attempted as compared to 40% of the primigravida. The success rate of ECV in the present study is maximum when ECV was performed at a gestational age of 38-39 weeks and when fetal weight was less than 3000 grams. Out of the 42 successful ECV cases, 4 babies (9.52%) had neonatal sepsis and 1 was still born (2.3%) which was unrelated to ECV.Conclusions: ECV is a valuable though under used option in the management of breech presentation at term. It is a relatively safe procedure, simple to learn and perform. Vigilance for breech presentation after 36 weeks is important. ECV at term using tocolytics should be part of the routine management of breech presentation.

Variations in the Management of Singleton Breech Presentation Throughout Scotland

1998 ◽  
Vol 43 (5) ◽  
pp. 144-145 ◽  
Author(s):  
S. Z. S. Yahya ◽  
J. Williams ◽  
A. Mathers ◽  
S. Bjornsson ◽  
A. D. Cameron ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Breech Presentation ◽  
Postal Questionnaire ◽  
External Cephalic Version ◽  
Breech Delivery ◽  
Vaginal Breech Delivery ◽  
Post Procedure ◽  
Line Management

Breech presentation occurs in 3–5% of deliveries and can be managed by either a trial of vaginal breech delivery (TOVBD), external cephalic version (ECV) or Caesarean section.1 A postal questionnaire was completed by 82% of Scottish consultant obstetricians and revealed wide variations in practice. Eighteen percent never offered ECV. Among those who did consensus was lacking on some contraindications. One-quarter sometimes performed ECV before 37 weeks gestation despite the possibility ofspontaneous version. Only 70% restricted ECV to one or more designated operators thereby maintaining levels of expertise. Variations were demonstrated in the use of tocolytics, and pre and post procedure investigations. Following failed ECV 28% considered a repeat attempt and 56% a TOVBD. TOVBD was not offered asjirst line management by one-fifth of respondents. Those who did varied in the pre-procedure investigations performed. Guidelines are required to ensure safe, consistent practice and avoid unnecessary Caesarean sections.

scholarly journals Zunanji obrat ploda na glavico v Porodnišnici Izola

2017 ◽  
Vol 86 ◽  
Author(s):  
Boštjan Lovšin ◽  
Mladen Mrkajić ◽  
Janja Zver-Skomina ◽  
Dušan Deisinger
Keyword(s):  
Caesarean Section ◽  
Amniotic Fluid ◽  
Breech Presentation ◽  
Muscle Relaxants ◽  
External Cephalic Version ◽  
Uterine Muscle ◽  
Obstetrics And Gynaecology ◽  
Almost All ◽  
Professional Guidelines ◽  
Fetal Position

Background: Almost all babies in breech presentation at term are delivered by caesarean section. Professional guidelines recommend an attempt of external cephalic version to reduce breech presentations at birth and thus the proportion of caesareans. Our aim was to analyse the clinical and ultrasound factors to predict the outcome of version and check the hypothesis, if the implementation of the external cephalic version helps to reduce the number of caesareans.Methods: The study included all attempts of external cephalic version after 36 weeks of pregnancy at the Department of Obstetrics and Gynaecology in Izola General Hospital from 2002 to 2010.Results: 68/143 (47.6 %) external cephalic versions were successful. the success of intervention was mostly influenced by a greater amount of amniotic fluid, higher fetal position in the pelvis and transverse or oblique lie of the fetus. With 100 attempts of external cephalic version 32 caesareans were avoided or one cesarean per 3.1 attempts.Conclusions: the study has confirmed that by performing external cephalic version the number of caesareans can be reduced. The proportion of successful versions was comparable to studies in the literature despite the minimal use of uterine muscle relaxants.

scholarly journals Knowledge, attitude and practice of obstetricians towards external cephalic version

2021 ◽  
Author(s):  
Aisha Moon ◽  
Saima Shabbir
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Success Rate ◽  
Current Trend ◽  
Breech Presentation ◽  
External Cephalic Version ◽  
Cesarean Section Rate ◽  
Safe Procedure ◽  
Attitude And Practice ◽  
Knowledge Attitude And Practice

Background: Breech presentation is found in 3-5% of pregnant women at term. The cause for this fetal presentation may vary from fetal to maternal. Management option for breech presentation includes assisted vaginal breech birth, caesarean section and external cephalic version. External cephalic version is a maneuver performed to avoid breech presentation at term labor and helping the obstetricians to avoid complications of cesarean section. The success rate of ECV is 50%. Considering a high success rate and low risks it can be concluded that ECV can help reduce cesarean section rate of any region. The objective of this study is to determine the knowledge, attitude and practice of healthcare practitioners towards external cephalic version.Methods: This is an observational cross-sectional study conducted by the postgraduate trainee of Kulsumbai Valika social security SITE hospital, Karachi, Pakistan. By purposive sampling selection, there were 50 consultant obstetricians that have been well informed and were willing to complete KAP study questionnaires were enrolled to participate.Results: A total of 50 participants were included, 70% had clinical experience of more than 10 years. 80% considered ECV a safe procedure.75% believe that effective knowledge and practice of ECV can bring down cesarean section rate. If encountered by client with breech presentation 69% will manage with elective LSCS (lower segment caesarean section), 26% with ECV and only 5% will manage with assisted breech vaginal birth.Conclusions: For uncomplicated singleton breech at term, both ACOG and RCOG recommend external cephalic version. In Pakistan the current trend involves performing cesarean section for breech presentation. Effective knowledge, Proper training, and adequate practice can improve ECV uptake in our country. 

Breech Presentation: Vaginal Delivery or Caesarean Section?

2016 ◽  
Vol 2 (1) ◽  
pp. 153
Author(s):  
Tomescu Cezar Laurentiu ◽  
Rodica Sîrbu ◽  
Emin Cadar ◽  
Brezeanu Dragos ◽  
Aneta Tomescu
Keyword(s):  
Retrospective Study ◽  
Caesarean Section ◽  
Vaginal Delivery ◽  
Total Population ◽  
Population Sample ◽  
Breech Presentation ◽  
Current Paper ◽  
Clinical Hospital ◽  
Obstetrics And Gynaecology ◽  
Number Of Patients

The incidence of breech presentation is approximately 3,97%. Breech presentation is considered as being “borderline eutocic” and it requires carefully monitoring both the foetus and the mother. The aim of the current paper is to evaluate the preffered method of delivery in case of breech presentation. The paper presents a retrospective study performed in the Obstetrics and Gynaecology Departments of the County Emergency Clinical Hospital “Sf. Apostol Andrei” in Constanta, during a period of 5 years (2010-2014). The methods of birth were analyzed for a lot of 1104 patients with breech presentation with ages ranging between 16 and 44 years old. The total number of patients who gave birth through vaginal delivery was of 139 patients, amounting to 12.59% of the total population sample. The number of patients that gave birth through C-section was 965, which amounts to 87.4% of the total population sample. Birth through C-section is preferred by both obstetricians and patients alike, due to the fact that vaginal delivery is associated with a higher foetal risk in breech presentation.

Cesarean delivery after successful external cephalic version of breech presentation at term: a comparative study

2004 ◽  
Vol 190 (3) ◽  
pp. 763-768 ◽  
Author(s):  
Yannik Vézina ◽  
Emmanuel Bujold ◽  
Jocelyne Varin ◽  
Gérald P Marquette ◽  
Marc Boucher
Keyword(s):  
Comparative Study ◽  
Cesarean Delivery ◽  
Breech Presentation ◽  
External Cephalic Version
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