The efficacy and safety of external cephalic version after a previous caesarean delivery.
BACKGROUND
External cephalic version (ECV) in the presence of a uterine scar is still considered a relative contraindication despite encouraging studies of the efficacy and safety of this procedure. We present our experience with this patient population, which is the largest cohort published to date.


OBJECTIVE
To evaluate the efficacy and safety of ECV in the setting of a prior caesarean delivery.


METHODS
A total of 158 patients with a fetus presenting as breech, who had an unscarred uterus, had an ECV performed. Similarly, 158 patients with a fetus presenting as breech, and who had undergone a prior caesarean delivery also underwent an ECV. Outcomes were compared.


RESULTS
ECV was successfully performed in 136/158 (86.1%) patients in the control group. Of these patients, 6/136 (4.4%) delivered by caesarean delivery. In the study group, 117/158 (74.1%) patients had a successful ECV performed. Of these patients, 12/117 (10.3%) delivered by caesarean delivery. There were no significant complications in either of the groups.


CONCLUSIONS
ECV may be successfully performed in patients with a previous caesarean delivery. It is associated with a high success rate, and is not associated with an increase in complications.
Department of Ophthalmology, Shaare Zedek Medical Center, Jerusalem, Israel.|Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, Jerusalem, Israel.
Yishay
Y
Weill
Department of Obstetrics & Gynecology, Meuhedet HMO, Jerusalem, Israel.
Raphael N
RN
Pollack
D000328:Adult; D001946:Breech Presentation / Q000628:therapy*; D002585:Cesarean Section / Q000009:adverse effects; D002921:Cicatrix / Q000209:etiology*; D005260:Female; D006801:Humans; D011247:Pregnancy; D014710:Version, Fetal; D055815:Young Adult
breech presentation; caesarean section; external cephalic version; fetal version; previous caesarean section; vaginal birth after caesarean