Outcome of External Cephalic Version in Terms of Success Rate and Fetomaternal Complications

Abstract

Objective:  To assess the outcome of external cephalic version for management of breech fetuses at term in terms of: ·  Success rate of ECV.    ·  Feto maternal complications.

Design:  Prospective interventional study.

Setting:  Department of Obstetrics and Gynaecology, Unit-III, Services Hospital, a tertiary care centre in Lahore, Pakistan.

Patients:  From July 19, 2007 to January 14, 2009, the study was conducted involving pregnant women with breech presentation between 37 - 41 weeks. An external cephalic version was carried out. Data was collected for identifying the success or failure of external cephalic version and feto maternal complications.

Main Outcome Measures:  Maternal and fetal outcome measures assessed in terms of:  ·  Success rate of external cephalic version.    ·  Maternal and fetal complications.

Statistical Data Analysis:  Collected Data was entered into SPSS (Statistical Package for Social Sciences) version 12.0 and analyzed descriptively. Mean and SD was calculated for quantitation variable like gestational age and percentages were calculated for qualitative variables like gravida, complication etc.

Results:  Forty women were included in the study. External cephalic version was successful in 60% patients. The majority (70.83%) of this group achieved the vaginal delivery. The rate of caesarean section was 29.16%. The most common indication for caesarean section was fetal distress and failure to progress. There was no foetal or maternal adverse outcome except one in which membranes ruptured during the procedure. The majority of women were satisfied with external cephalic version.

Conclusion:  External cephalic version has good success rate. External cephalic version is relatively safe, simple to learn and perform. Well equipped Obstetrics Units should routinely offer the procedure in selective cases. ECV helps to avoid a signi-ficant number of caesarean sections. Properly counseled women are satisfied with the procedure.

Keywords:  External Cephalic Version. Breech Presentation. Success Rate. Fetomaternal Complications.