External cephalic version at Izola Maternity Hospital

Abstract

Background : Almost all babies in breech presentation at term are delivered by caesarean section. Professional guidelines recommend an attempt of external cephalic version to reduce breech presentations at birth and thus the proportion of caesareans. Our aim was to analyse the clinical and ultrasound factors to predict the outcome of version and check the hypothesis, if the implementation of the external cephalic version helps to reduce the number of caesareans. Methods : The study included all attempts of external cephalic version after 36 weeks of pregnancy at the Department of Obstetrics and Gynaecology in Izola General Hospital from 2002 to 2010. Results : 68/143 (47.6 %) external cephalic versions were successful. the success of intervention was mostly influenced by a greater amount of amniotic fluid, higher fetal position in the pelvis and transverse or oblique lie of the fetus. With 100 attempts of external cephalic version 32 caesareans were avoided or one cesarean per 3.1 attempts. Conclusions : the study has confirmed that by performing external cephalic version the number of caesareans can be reduced. The proportion of successful versions was comparable to studies in the literature despite the minimal use of uterine muscle relaxants.