Successful but limited use of external cephalic version in Auckland

Abstract

External cephalic version (ECV) can effectively reduce the chance of non-cephalic presentation at birth and reduce caesarean section rate for breech presentation at term. It is recommended in New Zealand to offer ECV to all eligible women with breech presentation at term. This study aims to determine the ECV success rate at our hospital, factors that predict ECV success, and perinatal outcomes for women who had ECV, and to estimate the ECV attempt rate at our hospital. A prospective audit was performed of all women with singleton non-cephalic presentation>or=36 weeks who attended the ECV clinic at National Women's Health in Auckland from July 2002 to January 2006. Two hundred and fifty five women presented for ECV during the study period, and the ECV success rate was 59%. The strongest predictor of ECV success was an unengaged presenting part. Women with successful ECV had a vaginal birth rate of 67%. Three women needed to have an ECV attempt in order to prevent one caesarean section. We estimated that 26% of women with term breech presentation had an ECV attempt. ECV at National Women's Health is effective at reducing beech presentation at term and at restoring a caesarean section rate equivalent to that of cephalic singleton pregnancy at term. However, the low rate of referral should be addressed.