Cephalic version by postural management for breech presentation.
BACKGROUND
It is possible that maternal posture may influence fetal position. Many postural techniques have been used to promote cephalic version.


OBJECTIVE
The objective of this review was to assess the effects of postural management of breech presentation on measures of pregnancy outcome.


METHODS
The Cochrane Pregnancy and Childbirth trials register and Controlled Trials Register were searched. Date of last search: March 2000.


METHODS
Randomised and quasi-randomised trials comparing postural management with pelvic elevation for breech presentation, with a control group.


METHODS
Eligibility and trial quality were assessed by one or both reviewers.


RESULTS
Five studies involving a total of 392 women were included. No effect of postural management on the rate non-cephalic births was detected, either for the subgroup in which no external cephalic version was attempted, or for the group overall (relative risk 0.95, 95% confidence interval 0.81 to 1.11). No differences were detected for caesarean sections or Apgar scores below seven at one minute.


CONCLUSIONS
There is no evidence to support the use of postural management for breech presentation. The numbers of women studied to date remain relatively small.
Hofmeyr
G J
GJ
Effective Care Research Unit, University of the Witwatersrand, Frere/Cecilia Makiwane Hospitals, Private Bag 9047, East London 5200, Eastern Cape, South Africa. gjh@global.co.za.
Kulier
R
R
D001946:Breech Presentation; D002585:Cesarean Section; D016001:Confidence Intervals; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D011187:Posture; D011247:Pregnancy