title: Mode of delivery following successful external cephalic version: comparison with spontaneous cephalic presentations at delivery.
abstract: OBJECTIVE
  To compare the obstetric outcomes of pregnant women after successful external cephalic version (ECV) (cases) with a large group of pregnant women with a spontaneously occurring cephalic fetal position at delivery (controls).
  
  
  METHODS
  We conducted a retrospective matched cohort study in a teaching hospital in the Netherlands. Delivery outcomes of women with a successful ECV were compared with those of women with spontaneously occurring cephalic presentations, controlling for maternal age, parity, gestational age at delivery, and onset of labour (spontaneous or induced). Exclusion criteria were a history of Caesarean section, delivery at < 35 weeks, and elective Caesarean section. The primary outcome was the prevalence of Caesarean section and instrumental delivery in both groups; secondary outcomes were the characteristics of cases requiring intervention such as Caesarean section or instrumental delivery.
  
  
  RESULTS
  Women who had a successful ECV had a significantly higher Caesarean section rate than the women in the control group (33/220 [15%] vs. 62/1030 [6.0 %]; P < 0.001). There was no difference in the incidence of instrumental delivery (20/220 [9.1%] vs. 103/1030 [10%]). Comparison of characteristics of women in the cases group showed that nulliparity, induction of labour, and occiput posterior presentation were associated with Caesarean section and instrumental deliveries.
  
  
  CONCLUSIONS
  Compared with delivery of spontaneous cephalic presenta-tions, delivery of cephalic presenting babies following successful ECV is associated with an increased rate of Caesarean section, especially in nulliparous women and women whose labour is induced.
authors.affiliation: Department of Obstetrics and Gynaecology, Catharina Hospital, Eindhoven, the Netherlands.
authors.forename: Simone M I
authors.initials: SM
authors.lastname: Kuppens
authors.affiliation: Department of Obstetrics and Gynaecology, McMaster University, Hamilton ON; Department of Midwifery Science VU Medical Center, Amsterdam, the Netherlands.
authors.forename: Eileen K
authors.initials: EK
authors.lastname: Hutton
authors.affiliation: Department of Obstetrics and Gynaecology, Catharina Hospital, Eindhoven, the Netherlands.
authors.forename: Tom H M
authors.initials: TH
authors.lastname: Hasaart
authors.affiliation: Department of Obstetrics and Gynaecology, Catharina Hospital, Eindhoven, the Netherlands.
authors.forename: Nassira
authors.initials: N
authors.lastname: Aichi
authors.affiliation: Department of Midwifery Science, Zuyd University, Maastricht, the Netherlands.
authors.forename: Henrica A
authors.initials: HA
authors.lastname: Wijnen
authors.affiliation: Department of Medical Health Psychology, University of Tilburg, Tilburg, the Netherlands.
authors.forename: Victor J M
authors.initials: VJ
authors.lastname: Pop
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002585:Cesarean Section / Q000706:statistics & numerical data*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007746:Labor Presentation; D007751:Labor, Induced; D010298:Parity; D011247:Pregnancy; D012189:Retrospective Studies; D014710:Version, Fetal; D055815:Young Adult
keywords: Caesarean section; breech presentation; external cephalic version; instrumental delivery