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Cesarean risk after successful external cephalic version: a matched, retrospective analysis

Abstract

Objective:

To determine the odds of cesarean, operative vaginal delivery and vaginal birth after cesarean after successful external cephalic version (ECV) compared with singleton pregnancies eligible for a trial of labor.

Study Design:

A matched case–control study was performed using the Memorial Care OBStat Database from 1 January 1998 to 31 July 2006. We identified 197 participants who underwent a successful ECV (study group) and compared them with the next two women presenting for labor management, matched for parity, gestational age, delivery history (previous cesarean delivery) and type of labor (spontaneous or induced).

Result:

There was no significant difference in the adjusted matched odds of cesarean delivery between the study group and control group overall (16.8 vs 11.9%; odds ratio (OR) 1.70; 95% confidence interval (CI) 0.98 to 2.97), even when subanalyzed according to parity. There was also no significant difference in adjusted matched odds of operative vaginal delivery for the study group and control group, 15.9 vs 8.9% (OR 1.06; 95% CI 0.32 to 3.51). Among patients with a prior cesarean, those who underwent successful ECV had a cesarean delivery rate of 11.1% compared with 16.7% in the matched control group (OR 0.59; 95% CI 0.47 to 7.43).

Conclusion:

Cesarean delivery and operative vaginal delivery rates following successful ECV are not increased in our data set compared with matched controls, even in patients with a prior cesarean delivery. This information may be useful when counseling patients who are contemplating an ECV attempt due to non-cephalic presentation at term.

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References

  1. Hannah M, Hannah W, Hewson S, Hodnett E, Saigal S, Willan A . Planned cesarean section versus planned vaginal birth for breech presentation at term: a randomized multicentre trial. The Lancet 2000; 356: 1375–1383.

    Article  CAS  Google Scholar 

  2. Saling EM . External cephalic version under tocolysis. J Perinatal Med 1975; 3: 115.

    Article  CAS  Google Scholar 

  3. American College of Obstetricians and Gynecologists. External Cephalic Version (February 2000).

  4. Chan LY, Tang JL, Tsoi KF, Fok WY, Chan LW, Lau TK . Intrapartum cesarean delivery after successful external cephalic version: a meta-analysis. Obstet Gynecol 2004; 104: 155–160.

    Article  CAS  Google Scholar 

  5. Chan LKS, Leung TK, Fok WY, Chan LW, Lau TK . High incidence of obstetric interventions after successful external cephalic version. BJOG 2002; 109: 627–631.

    Article  Google Scholar 

  6. Lau TK, Lo KWK, Rogers M . Pregnancy outcome after successful external cephalic version for breech presentation at term. Am J Obstet Gynecol 1997; 176: 218–223.

    Article  CAS  Google Scholar 

  7. Laros Jr RK, Flanagan TA, Kilpatrick SJ . Management of term breech presentation: a protocol of external cephalic version and selective trial of labor. Am J Obstet Gynecol 1995; 172: 1916–1923.

    Article  Google Scholar 

  8. Vezina Y, Bujold E, Varin J, Marquette G, Boucher M . Cesarean delivery after successful external cephalic version of breech presentation at term: a comparative study. Am J Obstet Gynecol 2004; 190: 763–768.

    Article  Google Scholar 

  9. Ben-Haroush A, Perri T, Bar J, Yogev Y, Kaplan B . Mode of delivery following successful external cephalic version. Am J Perinatol 2002; 19 (7): 355–360.

    Article  Google Scholar 

  10. Wax JR, Sutula K, Lerer T, Steinfeld JD, Ingardia CJ . Labor and delivery following successful external cephalic version. Am J Perinatol 2000; 17: 183–186.

    Article  CAS  Google Scholar 

  11. Siddiqui D, Stiller RJ, Collins J, Laifer SA . Pregnancy outcome after successful external cephalic version. Am J Obstet Gynecol 1999; 181: 1092–1095.

    Article  CAS  Google Scholar 

  12. Egge T, Schauberger C, Shaper A . Dysfunctional labor after external cephalic version. Obstet Gynecol 1994; 80: 771–773.

    Google Scholar 

  13. Schachter M, Kogan S, Blickstein I . External cephalic version after previous cesarean section—a clinical dilemma. Int J Gynecol Obstet 1994; 45: 17–20.

    Article  CAS  Google Scholar 

  14. de Meeus JB, Ellia F, Magnin G . External cephalic version after previous cesarean section: a series of 38 cases. Eur J Obstet Gynecol Reprod Biol 1998; 81: 65–68.

    Article  CAS  Google Scholar 

  15. Flamm BL . External cephalic version after previous cesarean section. Am J Obstet Gynecol 1991; 165: 370–372.

    Article  CAS  Google Scholar 

  16. Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Menacker F, Kirmeyer S et al. Birth: Final Data for 2005. Natl Vital Stat Rep 2007; 56 (6): 1–104.

    PubMed  Google Scholar 

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Correspondence to C Clock.

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Synopsis

Successful external cephalic version does not seem to be associated with increased odds of subsequent cesarean delivery compared with matched controls.

Conflict of interest

The authors of this paper declare no conflict of interest.

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Clock, C., Kurtzman, J., White, J. et al. Cesarean risk after successful external cephalic version: a matched, retrospective analysis. J Perinatol 29, 96–100 (2009). https://doi.org/10.1038/jp.2008.227

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