Delivery mode and neonatal outcome after a trial of external cephalic version (ECV): A prospective trial of vaginal breech versus cephalic delivery

Joscha Reinhard*, Nicole Sänger, Lars Hanker, Lena Reichenbach, Juping Yuan, Eva Herrmann, Frank Louwen

*Corresponding author for this work
10 Citations (Scopus)

Abstract

Objective: To examine the delivery mode and neonatal outcome after a trial of external cephalic version (ECV) procedures. Study design: This is an interim analysis of an ongoing larger prospective off-centre randomised trial, which compares a clinical hypnosis intervention against neuro-linguistic programming (NLP) of women with a singleton breech foetus at or after 370/7 (259 days) weeks of gestation and normal amniotic fluid index. Main outcome measures were delivery mode and neonatal outcome. Results: On the same day after the ECV procedure two patients (2 %), who had unsuccessful ECVs, had Caesarean sections (one due to vaginal bleeding and one due to pathological CTG). After the ECV procedure 40.4 % of women had cephalic presentation (n = 38) and 58.5 % (n = 55) remained breech presentation. One patient remained transverse presentation (n = 1; 1.1 %). Vaginal delivery was observed by 73.7 % of cephalic presentation (n = 28), whereas 26.3 % (n = 10) had in-labour Caesarean sections. Of those, who selected a trial of vaginal breech delivery, 42.4 % (n = 14) delivered vaginally and 57.6 % (n = 19) delivered via Caesarean section. There is a statistically significant difference between the rate of vaginal birth between cephalic presentation and trial of vaginal breech delivery (p = 0.009), however, no difference in neonatal outcome was observed. Conclusion: ECV is a safe procedure and can reduce not only the rate of elective Caesarean sections due to breech presentation but also the rate of in-labour Caesarean sections even if a trial of vaginal breech delivery is attempted.

Original languageEnglish
JournalArchives of Gynecology and Obstetrics
Volume287
Issue number4
Pages (from-to)663-668
Number of pages6
ISSN0932-0067
DOIs
Publication statusPublished - 01.04.2013

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