Association Between Hospitals' Cesarean Delivery Rates For Breech Presentation And Their Success Rates For External Cephalic Version

2022 ◽  
Author(s):  
Yoann Athiel ◽  
Aude Girault ◽  
Camille Le Ray ◽  
François Goffinet
Keyword(s):  
Cesarean Delivery ◽  
Breech Presentation ◽  
External Cephalic Version ◽  
Success Rates

Cesarean delivery after successful external cephalic version of breech presentation at term: a comparative study

2004 ◽  
Vol 190 (3) ◽  
pp. 763-768 ◽  
Author(s):  
Yannik Vézina ◽  
Emmanuel Bujold ◽  
Jocelyne Varin ◽  
Gérald P Marquette ◽  
Marc Boucher
Keyword(s):  
Comparative Study ◽  
Cesarean Delivery ◽  
Breech Presentation ◽  
External Cephalic Version

scholarly journals Maternal and Neonatal Outcomes after Attempted External Cephalic Version among Women with One Previous Cesarean Delivery

2018 ◽  
Vol 08 (04) ◽  
pp. e349-e354 ◽  
Author(s):  
Rodney McLaren ◽  
Fouad Atallah ◽  
Nelli Fisher ◽  
Howard Minkoff
Keyword(s):  
Cesarean Delivery ◽  
Retrospective Cohort ◽  
Adverse Outcomes ◽  
Neonatal Outcomes ◽  
External Cephalic Version ◽  
Multivariable Logistic Regression Analysis ◽  
Success Rates ◽  
Trial Of Labor ◽  
Maternal And Neonatal Outcomes ◽  
Previous Cesarean

Objective This study was aimed to evaluate success rates of (1) external cephalic version (ECV) among women with one prior cesarean delivery (CD) and (2) maternal and neonatal outcomes after ECV among women with prior CD. Study Design Two linked studies using U.S. Natality Database were performed. First we performed a retrospective cohort comparing ECV success rates of women with prior CD and women without prior CD. Then we compared the outcomes of TOLACs (trial of labor after cesarean delivery) that occurred after ECV with those that occurred without ECV. Multivariable logistic regression analysis was used to estimate adverse outcomes. Results A total of 715 women had ECV after 36 weeks with prior CD and 9,976 had ECV without prior scar. ECV success rate with scar was 80.6% and without scar was 86.4% (p < 0.001). Seven hundred and sixteen women underwent TOLAC after ECV attempt and 234,617 underwent TOLAC without a preceding attempt. Women with preceding version had increased risks of maternal transfusion (1 vs. 0.4%, adjusted OR [odds ratio]: 2.48 [95% CI (confidence interval): 1.17–5.23]), unplanned hysterectomy (0.4 vs. 0.06%, adjusted OR: 6.90 [95% CI: 2.19–21.78]), and low 5-minute Apgar's score (2.5 vs. 1.5%, adjusted OR: 1.76 [95% CI: 1.10–2.82]). Conclusion Women with prior CD may have a decrease in the rate of successful ECV. While the absolute risks are low, ECV appears to increase risks of adverse maternal and neonatal outcomes among women undergoing a trial of labor.

Cesarean delivery after successful external cephalic version of breech presentation at term in japanese population

2005 ◽  
Vol 193 (6) ◽  
pp. S129
Author(s):  
Mihyon Son ◽  
Shimoya Koichiro ◽  
Kinugasa Yukiko ◽  
Tsubouchi Hiroaki ◽  
Hayashi Shusaku ◽  
...  
Keyword(s):  
Cesarean Delivery ◽  
Japanese Population ◽  
Breech Presentation ◽  
External Cephalic Version

scholarly journals Correlation of Obesity with External Cephalic Version Success among Women with One Previous Cesarean Delivery

2020 ◽  
Vol 10 (03) ◽  
pp. e324-e329
Author(s):  
Rodney McLaren ◽  
Fouad Atallah ◽  
Nelli Fisher ◽  
Howard Minkoff
Keyword(s):  
Success Rate ◽  
Cesarean Delivery ◽  
Adverse Outcomes ◽  
External Cephalic Version ◽  
Obese Women ◽  
Success Rates ◽  
Cross Sectional ◽  
The Relationship ◽  
Repeat Cesarean Delivery ◽  
Previous Cesarean

Abstract Objective Our aim was to assess the correlation of body mass index (BMI) with the success rate of external cephalic version (ECV) among women with one prior cesarean delivery. Study Design A cross-sectional study of pregnant women with one previous cesarean delivery who underwent ECV. The relationship between BMI and success rate of ECV was assessed. Adverse outcomes were also compared between women with an ECV attempt, and women who had a repeat cesarean delivery. Data were extracted from the U.S. Natality Database from 2014 to 2017. Pearson's correlation coefficient was performed to assess the relationship between BMI and success rate of ECV. Results There were 2,329 women with prior cesarean delivery underwent an ECV attempt. The success rate of ECV among the entire cohort was 68.3%. There was no correlation between BMI and success rate of ECV (r = 0.024, p = 0.239). Risks of adverse maternal and neonatal outcomes were similar between the ECV attempt group and the repeat cesarean delivery group. Conclusion There was no correlation of BMI with the rate of successful ECV among women with one prior cesarean delivery. Given the similar success rates of ECV and adverse outcomes, obese women with one prior cesarean delivery should be offered ECV.

scholarly journals Predictors of Cephalic Vaginal Delivery Following External Cephalic Version: An Eight-Year Single-Centre Study of 447 Cases

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Natalie Kew ◽  
Jacobus DuPlessis ◽  
Domenic La Paglia ◽  
Katherine Williams
Keyword(s):  
Success Rate ◽  
Vaginal Delivery ◽  
Birth Outcome ◽  
Mode Of Delivery ◽  
Breech Presentation ◽  
International Standards ◽  
External Cephalic Version ◽  
Normal Vaginal Delivery ◽  
Success Rates ◽  
Hospital Data

Introduction. Our study aims to investigate and evaluate (1) rates of success of ECV for breech presentation at term at the Royal Women’s Hospital in comparison to international standards; (2) mode of delivery following ECV; (3) factors influencing success rates of ECV at the Royal Women’s Hospital. Methods. An audit of all women who underwent ECV between the years 2007 and 2014 at the Royal Women’s Hospital as public patients was completed. Data parameters were collected from paper and electronic patient files at the Women’s Hospital. Data was collected to analyse the effect of the following parameters on ECV success and birth outcome: age, parity, gestational age, BMI, AFI, and tocolytic use. These parameters were analysed to determine their effect on ECV outcome and birth outcome. Results. The Women’s Hospital, Melbourne, has an ECV success rate of approximately 37%. Of the patients undergoing ECV, 29% proceeded to normal vaginal delivery. Predictors of successful ECV included low BMI, multiparity, and AFI more than 16 (P<0.05). The only predictor of cephalic vaginal delivery following ECV was multiparity. Negative predictors of cephalic delivery were low AFI and nulliparity. Conclusions. The success rate of ECV at the Women’s Hospital, Melbourne, is in line with global standards.

scholarly journals External Cephalic Version in Cases of Imminent Delivery at Preterm Gestational Ages: A Prospective Series

2019 ◽  
Vol 09 (04) ◽  
pp. e384-e388
Author(s):  
Meghan G. Hill ◽  
Kathryn L. Reed
Keyword(s):  
Success Rate ◽  
Cesarean Delivery ◽  
Study Design ◽  
Gestational Age ◽  
External Cephalic Version ◽  
Fetal Mortality ◽  
Success Rates ◽  
Clinical Series ◽  
Patient Series

Abstract Objective When delivery of a breech fetus is required at a preterm gestational age, Cesarean delivery is often recommended. We performed a prospective patient series to assess the success rate and safety of performing external cephalic version (ECV) procedures on preterm fetuses as an alternative to Cesarean delivery. Study Design We performed a prospective clinical series of patients who required delivery with a malpresenting fetus at a preterm gestational age. Results ECV procedures were successful in singletons 50% of the time. No significant complications or cases of fetal mortality were documented. Conclusion ECV at preterm gestational ages may be an appropriate approach to management in patients requiring delivery. Larger series are needed to further document success rates and risks of the procedure.

Effect of Intrathecal Bupivacaine Dose on the Success of External Cephalic Version for Breech Presentation

2017 ◽  
Vol 127 (4) ◽  
pp. 625-632 ◽  
Author(s):  
Laurie A. Chalifoux ◽  
Jeanette R. Bauchat ◽  
Nicole Higgins ◽  
Paloma Toledo ◽  
Feyce M. Peralta ◽  
...  
Keyword(s):  
Success Rate ◽  
Cesarean Delivery ◽  
Meta Analysis ◽  
Randomized Study ◽  
Mode Of Delivery ◽  
Breech Presentation ◽  
External Cephalic Version ◽  
Double Blind ◽  
Additional Increase ◽  
Dose Response Effect

Abstract Background Breech presentation is a leading cause of cesarean delivery. The use of neuraxial anesthesia increases the success rate of external cephalic version procedures for breech presentation and reduces cesarean delivery rates for fetal malpresentation. Meta-analysis suggests that higher-dose neuraxial techniques increase external cephalic version success to a greater extent than lower-dose techniques, but no randomized study has evaluated the dose–response effect. We hypothesized that increasing the intrathecal bupivacaine dose would be associated with increased external cephalic version success. Methods We conducted a randomized, double-blind trial to assess the effect of four intrathecal bupivacaine doses (2.5, 5.0, 7.5, 10.0 mg) combined with fentanyl 15 μg on the success rate of external cephalic version for breech presentation. Secondary outcomes included mode of delivery, indication for cesarean delivery, and length of stay. Results A total of 240 subjects were enrolled, and 239 received the intervention. External cephalic version was successful in 123 (51.5%) of 239 patients. Compared with bupivacaine 2.5 mg, the odds (99% CI) for a successful version were 1.0 (0.4 to 2.6), 1.0 (0.4 to 2.7), and 0.9 (0.4 to 2.4) for bupivacaine 5.0, 7.5, and 10.0 mg, respectively (P = 0.99). There were no differences in the cesarean delivery rate (P = 0.76) or indication for cesarean delivery (P = 0.82). Time to discharge was increased 60 min (16 to 116 min) with bupivacaine 7.5 mg or higher as compared with 2.5 mg (P = 0.004). Conclusions A dose of intrathecal bupivacaine greater than 2.5 mg does not lead to an additional increase in external cephalic procedural success or a reduction in cesarean delivery.

Fetal Malpresentation in Pregnancy

2020 ◽  
Author(s):  
Afshin Azimirad ◽  
Errol R. Norwitz
Keyword(s):  
Vaginal Delivery ◽  
Medical Center ◽  
Breech Presentation ◽  
Obstetric Care ◽  
External Cephalic Version ◽  
Breech Delivery ◽  
Advantages And Disadvantages ◽  
Ultrasound Evaluation ◽  
Elective Repeat Cesarean ◽  
Anatomical Part

Fetal presentation refers to that anatomical part of the fetus that presents at the maternal pelvic inlet. The most common and most desirable fetal presentation is cephalic (head first). Any presentation other than cephalic is referred to as a malpresentation. Breech is the most common fetal malpresentation. The prevalence of breech presentation varies with gestational age (25% at 28 weeks and 3-5% of at term). Ultrasound evaluation is the gold standard for the diagnosis of fetal presentation. External cephalic version (ECV) refers to a series of manual manipulations designed to convert a malpresenting fetus to cephalic to promote vaginal delivery. There are two strategies around the timing of ECV; at 36-37 weeks and/or at or shortly after 39 weeks’ gestation. Each has advantages and disadvantages. Currently, most breech pregnancies at term are delivered by cesarean at 39 weeks prior to the onset of labor. Malpresentation is the second most common indication for planned cesarean (behind elective repeat cesarean). Vaginal delivery for a breech fetus at term should only be attempted if the mother is strongly motivated, if the obstetric care provider is experienced, and if the medical center has the requisite facilities to manage any and all complications. This review contains 3 figures, 2 tables, and 66 references. Keywords: fetal presentation, malpresentation, breech presentation, ultrasound evaluation, external cephalic version (ECV), cesarean delivery, vaginal breech delivery

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