Safety and efficacy of external cephalic version for women with a previous cesarean delivery.
OBJECTIVE
To evaluate the success and morbidity rates for attempted external cephalic version (ECV) in patients with one previous cesarean delivery (CD) and a breech-presenting fetus at term.


METHODS
This is a retrospective study of outcomes of ECV at our institution for all women with one previous CD and a breech-presenting fetus at term between January 1997 and June 2005. A literature review was also performed as a Medline search (1966-2006).


RESULTS
ECV was attempted for 42 women with a breech-presenting fetus and previous CD. The success rate of ECV was 74.0%, and 84% of women with successful ECV delivered vaginally. All fetal and maternal outcomes were favorable. Only four Medline reports met our inclusion criteria, representing a total of 124 patients and a mean ECV success rate of 76.6%. Thus we assessed 166 cases of attempted ECV and find an average ECV success rate of 76.5% and favorable fetal and maternal outcomes.


CONCLUSIONS
Women with a breech-presenting fetus at term and previous CD, who desire a trial of labor, should be counseled regarding the accumulating evidence about the efficacy and apparently safety of this procedure and may be offered an ECV attempt.
Sela
Hen Y
HY
Department of Obstetrics & Gynecology, Hadassah Hebrew University Medical Center, Ein-Kerem, P.O. Box 12000, Jerusalem 91120, Israel. henys@hadassah.org.il
Fiegenberg
Tomer
T
Ben-Meir
Assaf
A
Elchalal
Uriel
U
Ezra
Yossef
Y
D001946:Breech Presentation; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D016064:Vaginal Birth after Cesarean; D014710:Version, Fetal / Q000706:statistics & numerical data*