This has resulted in resurgence of external cephalic version as an effective maneuver, which can result in significant reduction in cesarean section rate.
External cephalic version for breech presentation at term.
Women were excluded when their parity was >4; if there were contraindications for labor, vaginal delivery, external cephalic version, or early external cephalic version; or if the subject planned to move away during the pregnancy.
After enrollment, a screening ultrasound was done to obtain baseline fetal information prior to randomization to either early external cephalic version at 34 to 36 weeks or delayed external cephalic version at 37 to 38 weeks.
Key Words: Breech Pregnancy, External Cephalic version, Fetomaternal complication, Caesarian section.
External cephalic version is a procedure used during pregnancy to try to turn a breech fetus to cephalic by externally maneuvering the fetus through the maternal abdomen.
Management options may vary from institution to institution, however, because of limited availability of certain services--such as the expertise required for a trial of external cephalic version
, the availability of on-site cesarean delivery capabilities, and patient and clinician preferences.
George Carson, one of the investigators on the Early External Cephalic Version
2 (ECV2) Trial.
Patients received analgesic intervention and terbutaline timed to provide peak analgesic and uterine relaxant effect at the time of external cephalic version
, said Dr.
Emmanuel Bujold, a coordinator of a prospective observational study of external cephalic version
(ECV) at Sainte-Justine Hospital at the University of Montreal.
The finding, from a prospective study of more than 1,300 women, suggests that a trial of external cephalic version
(ECV) before 36 weeks' gestation may not be optimal, said Dr.
All pregnant women at his institution between 1988 and 2001 who underwent an attempted external cephalic version
of a normal term singleton in breech position had their amniotic fluid volumes measured immediately before the attempted version.
A total of 233 women from seven countries who had breech presentations were randomized to external cephalic version
(ECV) at 34-36 weeks' gestation or 37-38 weeks.
Yet in one prospective study, nine external cephalic versions
were successful in a group of 31 women receiving nitroglycerin.