The efficacy of external cephalic version and its impact on the breech experience
Article Abstract:
During delivery, when the feet or the buttocks of a fetus present first rather than the head, it is considered a breech delivery. Breech presentations are more difficult to deliver than head presentations. To reduce the risks involved with a breech delivery, particularly if it is a premature delivery, cesarean section has developed into the delivery mode of choice. Although the death rate for newborns is reduced by cesarean section, the newborn complication rate does not differ following vaginal and cesarean deliveries. The technique of external cephalic version involves turning the fetus to present the head first (vertex position) by manually manipulating the fetus. This procedure has been performed since the 16th century. However, the use of ultrasonographic imaging of the fetus, drugs that can control early labor, and electronic fetal monitoring has made cephalic version a safer procedure. The experience of cephalic version performed at term and its impact on the cesarean section rate was determined for a large obstetrical service. Of the 357 breech deliveries recorded, 112 patients were seen for cephalic version. Cephalic version successfully converted a breech presentation to vertex in 47 patients (48.9 percent). Thirty-eight of the successful cephalic versions were delivered vaginally (80.8 percent), eight patients were delivered by cesarean section (17.2 percent) and one was lost to follow-up. Of the 49 unsuccessful cephalic versions, 38 (77.5 percent) were delivered by cesarean section and five (10.2 percent) were delivered vaginally. The most common reason why the fetus was delivered by cesarean in the successfully converted fetuses was failure to descend through the birth canal. The most common reason for a cesarean section in the unsuccessful cephalic versions was breech presentation. There were no maternal or fetal complications reported after cephalic version. Almost 90 percent of all term breech presentations were delivered by cesarean section. The technique of cephalic version reduced the cesarean section rate by 0.6 percent in 1988. Cephalic version is a safe method of turning breech fetuses, but since the impact on the cesarean section rate was small, other methods which can lower this rate should be investigated. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0002-9378
Year: 1990
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Pregnancy outcome after successful external cephalic version for breech presentation at term
Article Abstract:
The use of external cephalic version in pregnancies with breech presentations may reduce the use of cesarean section but may not be without significant risk. External cephalic version refers to the attempt by the doctor to turn the unborn fetus to the head first position before delivery. Researchers analyzed the outcomes of 241 term pregnancies on which 243 attempts at external cephalic version were performed. Version was successful in 169 pregnancies. One patient experienced premature detachment of the placenta. Difficult labor, fetal distress, and cesarean section were higher than normal among patients with successful versions.
Publication Name: American Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0002-9378
Year: 1997
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Effect of external cephalic version at term on fetal circulation
Article Abstract:
Turning a breech baby around so the head comes out first affects blood flow in the baby's brain, but this is probably just a normal response to the procedure. A breech birth is one where the baby comes out feet first.
Publication Name: American Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0002-9378
Year: 2000
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