Postgraduate Research Training in Reproductive Health
Fudan University, Shanghai
Questions and answers
External cephalic version
organised by
The Fudan University, Shanghai
The Geneva Foundation for Medical Education and Research (GFMER)
The UNDP/UNFPA/WHO/World Bank Special Programme for Research in Human Reproduction,
Department of Reproductive Health and Research, Family and Community Health
Cluster World Health Organization (WHO/RHR)
The International Association of Maternal and Neonatal Health (IAMANEH)
in collaboration with
The Department of Health of the Canton
of Geneva
The Faculty of Medicine, Geneva University and
The Geneva Medical Association
External cephalic version at term and fetal distress
A Cochrane systematic review on External Cephalic version for breech presentation at term showed that ECV can lead to reduction of non-cephalic presentation at delivery by 50% or more and a reduction in C/S rate of 30% or more.
No differences between the groups with regard to neonatal outcomes, such as Apgar score at 1 or 5minutes, neonatal ICU admission or perinatal death. However, the numbers reported were small and do not have an accurate assessment of the risks of ECV.
Complications such as vaginal bleeding, abruptio placenta and fetal death are rare but have been described mainly when ECV was done before term.
Important is to determine the accurate presentation of the head and breech.
Tocolysis can be used, especially after failure of version.
Performing ECV under certain conditions, e.g. during onset of labour, after previous C/S needs to be assessed.
External Cephalic version before term did not show any differences for the above outcomes
References
- Hofmeyr GJ, Kulier R. External cephalic version for breech presentation at term. Cochrane Database Syst Rev. 2000;(2):CD000083. [PubMed]
- Hofmeyr GJ. External cephalic version for breech presentation before term. Cochrane Database Syst Rev. 2000;(2):CD000084. [PubMed]