[External cephalic version: experience about 237 versions at Port-Royal maternity].
OBJECTIVE
To evaluate the effectiveness of external cephalic version for reducing the rate of cesarean section by preserving fetal safety.


METHODS
A retrospective review of 237 external cephalic versions between January 1, 1998 and December 31, 2000 was conducted at Port Royal maternity.


RESULTS
The success rate of external cephalic version was 50.6%. When version failed vaginal birth could be allowed after strict evaluation. The rate of cesarean section was 12.5% in the success group and 53% in the unsuccessful group, two thirds were planned. The overall rate of vaginal birth among breech presentations was 67%. After version there were 3.4% abnormal fetal heart rate tracings and 2.9% positive Kleihauer tests. No major complications occurred. Successful external cephalic version was associated with statistically significant higher multiparity, complete breech out of the pelvis and normal amniotic fluid Volume.


CONCLUSIONS
External cephalic version reduces the cesarean section rate by about 20.5% among breech presentations and so, lowers maternal morbidity. External cephalic version could be proposed to the patients when safety criteria are respected and close fetal monitoring is maintained.
Le Bret
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T
Maternité Port Royal, CHU Cochin-Port-Royal, 127, boulevard Port-Royal, 75014 Paris. tlebret@hopital-dcss.org
Grangé
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G
Goffinet
F
F
Cabrol
D
D
D001946:Breech Presentation; D002585:Cesarean Section / Q000706:statistics & numerical data; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D005260:Female; D005323:Fetal Monitoring; D006340:Heart Rate, Fetal; D006801:Humans; D011247:Pregnancy; D012189:Retrospective Studies; D016896:Treatment Outcome; D014710:Version, Fetal / Q000009:adverse effects