title: Mode of delivery after successful external cephalic version: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To assess the mode of delivery in women after a successful external cephalic version by performing a systematic review and meta-analysis.
  
  
  METHODS
  We searched MEDLINE, Embase, ClinicalTrials.gov, Cumulative Index to Nursing and Allied Health Literature, and the Cochrane Library for studies reporting on the mode of delivery in women after successful external cephalic version at term and women with a spontaneous cephalic-presenting fetus.
  
  
  METHODS
  Two reviewers independently selected studies, extracted data, and assessed study quality. The association between mode of delivery and successful external cephalic version was expressed as a common odds ratio with a 95% confidence interval (CI).
  
  
  RESULTS
  We identified three cohort studies and eight case-control studies, reporting on 46,641 women. The average cesarean delivery rate for women with a successful external cephalic version was 21%. Women after successful external cephalic version were at increased risk for cesarean delivery for dystocia (odds ratio [OR] 2.2, 95% CI 1.6-3.0), cesarean delivery for fetal distress (OR 2.2, 95% CI 1.6-2.9), and instrumental vaginal delivery (OR 1.4, 95% CI 1.1-1.7).
  
  
  METHODS
  Women who have had a successful external cephalic version for breech presentation are at increased risk for cesarean delivery and instrumental vaginal delivery as compared with women with a spontaneous cephalic presentation. Nevertheless, with a number needed to treat of three, external cephalic version still remains a very efficient procedure to prevent a cesarean delivery.
authors.affiliation: Departments of Obstetrics and Gynecology, VU Medical Center and Academic Medical Center, Amsterdam, The Netherlands; and the Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia.
authors.forename: Marcella
authors.initials: M
authors.lastname: de Hundt
authors.forename: Joost
authors.initials: J
authors.lastname: Velzel
authors.forename: Christianne J
authors.initials: CJ
authors.lastname: de Groot
authors.forename: Ben W
authors.initials: BW
authors.lastname: Mol
authors.forename: Marjolein
authors.initials: M
authors.lastname: Kok
mesh_terms: D001946:Breech Presentation / Q000628:therapy; D002585:Cesarean Section / Q000706:statistics & numerical data*; D004420:Dystocia / Q000601:surgery; D005260:Female; D006801:Humans; D009772:Obstetrical Forceps / Q000706:statistics & numerical data; D011247:Pregnancy; D014710:Version, Fetal