title: Predictors for a successful external cephalic version: a single centre experience.
abstract: OBJECTIVE
  The external cephalic version (ECV) is one of the options patients presenting with a breech pregnancy should be offered. Various fetal, maternal and other predictors for a successful ECV have been published in the past.
  
  
  METHODS
  This is a retrospective multivariate analysis of our ECV patient database at the Department of Obstetrics and Gynaecology at the University Hospital Ulm. In an outpatient setting, patients with fetal breech position were routinely offered an ECV attempt after 36 weeks of gestation if the patient was willing to consent. Contraindications for ECV were placental abruption, placenta praevia, uterus malformations, regular contractions, premature rupture of membranes, and non-reassuring fetal heart rate patterns.
  
  
  RESULTS
  From January 1st 2010 to July 31st 2013, 444 patients with a minimum of 36 weeks gestational age (i.e. >35 + 6 weeks) attended our clinic with a breech presentation. Of those 118 had an ECV attempt and an extended ultrasound examination within 21 days. In 33 patients the procedure was successful (success rate 28 %). A multivariate binary logistic regression analysis revealed that an increased Amniotic Fluid Index (AFI; p < 0.001), at least one prior vaginal delivery (p = 0.002) or a high estimated fetal weight (p = 0.045) were significant independent predictors for a successful ECV. In our series no delivery occurred within 48 h after the ECV.
  
  
  CONCLUSIONS
  An ECV is a safe procedure. ECV should be offered as an option for the mother-to-be on the basis of an informed consent. Identified fetal and maternal factors can help to estimate the chances of success and in particular multi-parity and increased amniotic fluid seem to be associated with successful ECV.
authors.affiliation: Department of Obstetrics and Gynecology, University of Ulm, Prittwitzstr. 43, 89075, Ulm, Germany. florian.ebner@uniklinik-ulm.de.
authors.forename: Florian
authors.initials: F
authors.lastname: Ebner
authors.affiliation: Department of Obstetrics and Gynecology, University of Ulm, Prittwitzstr. 43, 89075, Ulm, Germany.
authors.forename: Thomas W P
authors.initials: TW
authors.lastname: Friedl
authors.affiliation: Department of Obstetrics and Gynecology, University of Ulm, Prittwitzstr. 43, 89075, Ulm, Germany.
authors.forename: Elena
authors.initials: E
authors.lastname: Leinert
authors.affiliation: Department of Obstetrics and Gynecology, University of Ulm, Prittwitzstr. 43, 89075, Ulm, Germany.
authors.forename: Amelie
authors.initials: A
authors.lastname: Schramm
authors.affiliation: Department of Obstetrics and Gynecology, University of Ulm, Prittwitzstr. 43, 89075, Ulm, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Reister
authors.affiliation: Department of Obstetrics and Gynecology, University of Ulm, Prittwitzstr. 43, 89075, Ulm, Germany.
authors.forename: Kristian
authors.initials: K
authors.lastname: Lato
authors.affiliation: Department of Obstetrics and Gynecology, University of Ulm, Prittwitzstr. 43, 89075, Ulm, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Janni
authors.affiliation: Department of Obstetrics and Gynecology, University of Ulm, Prittwitzstr. 43, 89075, Ulm, Germany.
authors.forename: Nikolaus
authors.initials: N
authors.lastname: DeGregorio
mesh_terms: D000328:Adult; D000653:Amniotic Fluid; D001946:Breech Presentation; D002585:Cesarean Section / Q000706:statistics & numerical data; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005260:Female; D020567:Fetal Weight; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015999:Multivariate Analysis; D007744:Obstetric Labor Complications / Q000209:etiology; D010298:Parity; D011247:Pregnancy; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D047928:Premature Birth; D012044:Regression Analysis; D012189:Retrospective Studies; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal; D014710:Version, Fetal / Q000379:methods*
keywords: Breech; Delivery; ECV; External cephalic version; Position