External cephalic version has a slight (2.4%)28 risk of silent feto-maternal hemorrhage, so all the rhesus-negative patients should be given anti-D prophylaxis after completion of the procedure; however we didn't have any such patient in our study.
External cephalic version is a valuable tool against the rising cesarean section rate and complementing this procedure by tocolysis can further add up to the success of the procedure.
Reisenberger, "Single institute experience, management, success rate, and outcome after external cephalic version at term," International Journal of Gynecology & Obstetrics, vol.
Sinclair, "Interventions for helping to turn term breech babies to head first presentation when using external cephalic version," Cochrane Database of Systematic Reviews, 2012.
Use of external cephalic version for breech pregnancy and mode of delivery for breech and twin pregnancy a survey of Canadian practitioners.J Obstet Gynaecol Can 2002;24:804-10.
The Early External Cephalic Version (ECV) 2 Trial: a n international multicentre randomised controlled trial of timing of ECV for Breech pregnancies.
Women were excluded when their parity was >4; if there were contraindications for labor, vaginal delivery,
external cephalic version, or early
external cephalic version; or if the subject planned to move away during the pregnancy.
Data Source: A study that randomized 1,532 women with breech presentations to either an early
external cephalic version or a later version performed at 37 weeks.
The success rate of
external cephalic version was 43% in the CSE group and 33% in the systemic analgesia group.
Predictors of
External Cephalic Version Success Odds Ratio P value Parity >0 2.25 .001 Tocolysis 1.73 .001 Amniotic fluid index >10 cm 1.56 .001 Estimated fetal weight >3,000 g 1.20 .154 Frank breech presentation 0.80 .088 Gestational age >38 weeks 0.74 .027 Maternal BMI >35 kg/[m.sup.2] 0.21 .001 Note: Results of a multivariate logistic regression analysis.
These data should be incorporated into informed consent procedures before an attempted
external cephalic version, he said.
Yet in one prospective study, nine
external cephalic versions were successful in a group of 31 women receiving nitroglycerin.