title: Delivery mode and neonatal outcome after a trial of external cephalic version (ECV): a prospective trial of vaginal breech versus cephalic delivery.
abstract: OBJECTIVE
  To examine the delivery mode and neonatal outcome after a trial of external cephalic version (ECV) procedures.
  
  
  METHODS
  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 37(0/7) (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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: St. Marienkrankenhaus Frankfurt, Richard-Wagner Straße 14, 60318 Frankfurt am Main, Germany. J.Reinhard@katharina-kasper.de
authors.forename: Joscha
authors.initials: J
authors.lastname: Reinhard
authors.forename: Nicole
authors.initials: N
authors.lastname: Sänger
authors.forename: Lars
authors.initials: L
authors.lastname: Hanker
authors.forename: Lena
authors.initials: L
authors.lastname: Reichenbach
authors.forename: Juping
authors.initials: J
authors.lastname: Yuan
authors.forename: Eva
authors.initials: E
authors.lastname: Herrmann
authors.forename: Frank
authors.initials: F
authors.lastname: Louwen
mesh_terms: D001946:Breech Presentation / Q000628:therapy*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D014219:Trial of Labor; D014710:Version, Fetal / Q000706:statistics & numerical data*