Women who
had a successful External Cephalic Version (ECV) are not at increased risk of
cesarean section as compared to women who had Spontaneous Cephalic Version
(SCV) says the results of a study published ahead of print on August 2, 2017 in
Journal of Obstetrics and Gynecology Canada.
This is first
study conducted to compare the outcome between spontaneous and external version
in breech presenting fetuses.
It is
estimated that term fetal malpresentation occurs in about 3% of pregnancies—and
is a common indication for cesarean. External Cephalic version is an important
tool to reduce the rate of cesarean births in breech presentation.
This secondary
analysis of Early External Cephalic Version Trial data identified 931 women who
had breech presenting fetuses between 34-36 weeks of pregnancy, but cephalic presentation
at term.
Out of these
study subjects, 557 women have undergone successful ECV while in 374 women the
fetus reverted spontaneously.
Obstetric
outcomes between the two groups were comparable: 96 women in ECV arm had
Cesarean section as compared to 76 in the SCV group. (adjusted OR [aOR] 0.89;
95% CI 0.63-1.26); 393 had vaginal delivery in ECV arm vs 268 in SCV arm. (aOR
0.92; 95% CI 0.68-1.24).
Women in the
ECV had 45% increased odds of undergoing instrumental intervention as compared to
women in SCV group. (aOR 1.55; 95% CI 0.96-2.50).
Multiparous
women with ECV were half as likely to require a cesarean section as compared to
women with spontaneous version or no version at all. ( aOR 0.45; 95% CI
0.26-0.80).
The authors
concluded, “Women with a cephalic-presenting fetus at birth as a result of
successful ECV are not at greater risk of obstetrical interventions at birth
when compared with women with fetuses who spontaneously turn to a cephalic
presentation in the third trimester.”
Media Courtesy: American Association of Family Physicians
Media Courtesy: American Association of Family Physicians
