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 easilyacquired. It has become a valuable option in the management of breech foetus at term. Aims of thisstudy were to determining those factors that were significantly associated with success of externalcephalic version (ECV) procedure. Method: This prospective interventional study was conducted atDepartment of Obstetrics and Gynaecology, Unit-III, Services Hospital, Lahore, Pakistan from July2007 to December 2009. Total of 56 patients who had undergone ECV was analysed descriptively andanalytically. Univariate and multivariate data analysis was performed. Pre-procedural factors (gravidity,gestational age, amniotic fluid index, placental location, type of breech, maternal obesity, foetalweight), and factors associated with the procedure itself (abdominal wall musculature tone, uterinetone, maternal anxiety, maternal threshold for pain, engagement of breech, number of attempts) wereassessed. Results: Thirty-three patients were successfully converted to vertex presentation. Inmultivariate 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 succeedwhen 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 increasedmaternal anxiety, lesser cooperation and ending in failure.Keywords: External cephalic version (ECV), breech

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Published

2012-06-01