PREDICTION MODEL FOR DETERMINING IMPORTANT FACTORS OF SUCCESS OF EXTERNAL CEPHALIC VERSION

Authors

  • Wasima Arif
  • Fauzia Maqsood
  • Marryam Iqbal
  • Zohra Khanum
  • Sohail Khursheed Lodhi
  • Muhammad Ghias

Abstract

Background: The External cephalic version (ECV) is a skill as well as an art that could be easily
acquired. It has become a valuable option in the management of breech foetus at term. Aims of this
study were to determining those factors that were significantly associated with success of external
cephalic version (ECV) procedure. Method: This prospective interventional study was conducted at
Department of Obstetrics and Gynaecology, Unit-III, Services Hospital, Lahore, Pakistan from July
2007 to December 2009. Total of 56 patients who had undergone ECV was analysed descriptively and
analytically. Univariate and multivariate data analysis was performed. Pre-procedural factors (gravidity,
gestational age, amniotic fluid index, placental location, type of breech, maternal obesity, foetal
weight), and factors associated with the procedure itself (abdominal wall musculature tone, uterine
tone, maternal anxiety, maternal threshold for pain, engagement of breech, number of attempts) were
assessed. Results: Thirty-three patients were successfully converted to vertex presentation. In
multivariate analysis, placenta, type of breach, station of breach and number of attempts (‰¤2 times)
were significantly associated factors with ECV procedure. Conclusion: ECV is most likely to succeed
when the patient has already one pregnancy and child birth, the breech is not engaged, and is flexed.
Procedure is usually successful within one or two attempts, whereas ongoing attempts lead to increased
maternal anxiety, lesser cooperation and ending in failure.
Keywords: External cephalic version (ECV), breech

References

Gimousky ML, Paul RH. Singleton breech presentation in

labour: Experience in 1980. Am J Obstet Gynecol

;143:733-9.

Amon E, Sibai BM, Anderson GD. How perinatologists

manage the problem of the presenting breech. Am J Perinatol

;5:247-50.

Hannah ME, Hannah WJ, Hewson SA, Hodnett ED, Saigal S,

Willan AR. Planned caesarean section versus planned vaginal

birth for breech presentation at term: a randomized multicentre

trial. Term Breech Trial Collaborative Group. Lancet 2000;

:1375-83.

Ranney B. The gentle art of external cephalic version. Am J

Obstet Gynecol 1973;116:239-51.

Zhang J, Bowes W, Fortney J. Efficacy of external cephalic

version: A review. Obstet Gynecol 1993;82:306-12.

Ferguson JE 2nd, Armstrong MA, Dyson DC. Maternal and

fetal factors affecting success of antepartum external cephalic

version. Obstet Gynecol 1987;70:722-5.

Fortunato S, Mercer L, Guzick D. External cephalic version

with tocolysis: Factors associated with success. Obstet Gynecol

;72:59-62.

Newman R, Peacock B, Van Dorsten J, Hunt H. Predicting

success of external cephalic version. Am J Obstet Gynecol

;169:245-50.

Lau T, Lo K, Wan D, Rogers MS. Predictors of successful

version at term: A prospective study. Br J Obstet Gynaecol

;104:798-802.

Fortunato SJ, Mercer LJ, Guzick DS. External cephalic version

with tocolysis: Factors associated with success. Obstet

Gynaecol 1988;72(1):59-62.

Lau TK, Lo KWK, Wan D, Rogers MS. Predictors of

successful external cephalic version at term: a prospective

study. Br J Obstet Gynaecol 1997;104:798-802.

Aisenbrey GA, Catanzarite VA, Nelson C. External cephalic

version: Predictors of success. Obstet Gynecol 1999;94:783-6.

Chan LYS, Yeung T, Fok WY, Chan LW, Lau TK. Prediction of

successful vaginal delivery in women undergoing external

cephalic version at term for breech presentation. Eur J Obstet

Gynecol Reprod Biol 2004;116:39-42.

Korman MT, Kimball KT, Reeves KO. Preterm external

cephalic version in an outpatient environment. Am J Obstet

Gynecol 1995;172:1734-41.

Zhang J, Bowes WA Jr, Fortney JA. Efficacy of external

cephalic version: a review. Obstet Gynecol 1993;82:306-12.

J Ayub Med Coll Abbottabad 2012;24(2)

http://www.ayubmed.edu.pk/JAMC/24-2/Wasima.pdf 17

Early ECV 2 Trial. Accessed October 30, 2007. Available at:

htpp://www.utoronyo.ca/miru/eecv2.

Ranney B. The gentle art of external cephalic version. Am J

Obstet Gynecol 1973;116:239-51.

Schorr SJ, Speights SE, Ross EL, Bofill JA, Rust OA, Norman

PF, et al. A randomized trial of epidural anesthesia to improve

external cephalic version success. Am J Obstet Gynecol

;177:1133-7.

Lau TK, Lo KWK, Wan D, Rogers M. Predictors of successful

external cephalic version at term: a prospective study. Br J

Obstet Gynecol 1997;104:789-802.

Impey I, Pandit M. Tocolysis for repeat external cephalic

version after a failed version for breech presentation at term: a

randomized double-blind placebo controlled trial. BJOG

;112:627-31.

Johnson RL, Elliott JP. Fetal acoustic stimulation, an adjunct to

external cephalic version:a double blinded, randomized

crossover study. Am J Obstet Gynecol 1995;173:1369-72.

Tasnim N, Mahmud G, Khurshid M. External cephalic version

with Salbutamol-success rate and predictors of success. J Coll

Physician Surg Pak 2009;19(2):91-4.

Hofmeyr G. Interventions to help external cephalic version for

breech presentation at term. Cochrane Database Syst Rev

;(1): CD000184.

Kok M, Van Der Steeg JW, Mol BW, Opmeer B, Van Der Post

JA. Which factors play a role in clinical decision-making in

external cephalic version? Acta Obstet Gynecol Scand

;87:31-5.

ACOG. Clinical Management Guidelines for ObstetricianGynecologists: External Cephalic Version. ACOG Practice Bull

;13:380-5.

Downloads

Published

2012-06-01

How to Cite

Arif, W., Maqsood, F., Iqbal, M., Khanum, Z., Lodhi, S. K., & Ghias, M. (2012). PREDICTION MODEL FOR DETERMINING IMPORTANT FACTORS OF SUCCESS OF EXTERNAL CEPHALIC VERSION. Journal of Ayub Medical College Abbottabad, 24(2), 14–17. Retrieved from https://jamc.ayubmed.edu.pk/index.php/jamc/article/view/2180

Issue

Vol. 24 No. 2 (2012): JOURNAL OF AYUB MEDICAL COLLEGE, ABBOTTABAD

Section

ORIGINAL ARTICLE

License

Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License  CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.

USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.

AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.