The introduction of external cephalic version at term into routine clinical practice.
External cephalic version (ECV) at > or = 37 weeks' gestation in suitable women with breech presentation was introduced in 1991 as a new management option at a University Teaching Hospital. After 16 months, the policy was audited by analysing a prospectively collected database of women offered ECV at term and by a retrospective review of all breech deliveries during the same period. A total of 52 women had ECV attempted with an immediate success rate of 46%. Four other cases had undergone spontaneous version by the time they attended for ECV. Of the remaining 72 breech deliveries, 49 were known to be breech and were not offered ECV; 39 of these had no contraindication (28% failure to offer ECV). Of the breech presentations, 22 remained undiagnosed until labour (18% of total study group). These results suggest that ECV at term can be introduced safely and without difficulty, with a strict protocol. Whilst the overall impact of ECV at term in clinical practice may be limited, if some vaginal breech deliveries and caesarean sections can be avoided it is a useful addition to the antenatal management of individual women with breech presentation.
Bewley
S
S
Department of Obstetrics and Gynaecology, University College and Middlesex School of Medicine, London, UK.
Robson
S C
SC
Smith
M
M
Glover
A
A
Spencer
J A
JA
D001946:Breech Presentation; D002985:Clinical Protocols; D036861:Delivery, Obstetric / Q000379:methods*; D004739:England; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D008485:Medical Audit; D017410:Practice Guidelines as Topic / Q000592:standards; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods / Q000592:standards*; D011446:Prospective Studies; D012189:Retrospective Studies; D015145:Tocolysis