Source
Maternité Port Royal, CHU Cochin-Port-Royal, 127, boulevard Port-Royal, 75014 Paris. tlebret@hopital-dcss.org
Abstract
OBJECTIVES:
To evaluate the effectiveness of external cephalic version for reducing the rate of cesarean section by preserving fetal safety.
MATERIALS AND METHODS:
A retrospective review of 237 external cephalic versions between January 1, 1998 and December 31, 2000 was conducted at Port Royal maternity.
RESULTS:
The success rate of external cephalic version was 50.6%. When version failed vaginal birth could be allowed after strict evaluation. The rate of cesarean section was 12.5% in the success group and 53% in the unsuccessful group, two thirds were planned. The overall rate of vaginal birth among breech presentations was 67%. After version there were 3.4% abnormal fetal heart rate tracings and 2.9% positive Kleihauer tests. No major complications occurred. Successful external cephalic version was associated with statistically significant higher multiparity, complete breech out of the pelvis and normal amniotic fluid Volume.
CONCLUSION:
External cephalic version reduces the cesarean section rate by about 20.5% among breech presentations and so, lowers maternal morbidity. External cephalic version could be proposed to the patients when safety criteria are respected and close fetal monitoring is maintained.