The Efficacy and Safety of External Cephalic Version After a Previous Caesarean Delivery

Aust N Z J Obstet Gynaecol. 2017 Jun;57(3):323-326. doi: 10.1111/ajo.12527. Epub 2016 Sep 14.

Abstract

Background: External cephalic version (ECV) in the presence of a uterine scar is still considered a relative contraindication despite encouraging studies of the efficacy and safety of this procedure. We present our experience with this patient population, which is the largest cohort published to date.

Aims: To evaluate the efficacy and safety of ECV in the setting of a prior caesarean delivery.

Materials and methods: A total of 158 patients with a fetus presenting as breech, who had an unscarred uterus, had an ECV performed. Similarly, 158 patients with a fetus presenting as breech, and who had undergone a prior caesarean delivery also underwent an ECV. Outcomes were compared.

Results: ECV was successfully performed in 136/158 (86.1%) patients in the control group. Of these patients, 6/136 (4.4%) delivered by caesarean delivery. In the study group, 117/158 (74.1%) patients had a successful ECV performed. Of these patients, 12/117 (10.3%) delivered by caesarean delivery. There were no significant complications in either of the groups.

Conclusions: ECV may be successfully performed in patients with a previous caesarean delivery. It is associated with a high success rate, and is not associated with an increase in complications.

Keywords: breech presentation; caesarean section; external cephalic version; fetal version; previous caesarean section; vaginal birth after caesarean.

MeSH terms

  • Adult
  • Breech Presentation / therapy*
  • Cesarean Section* / adverse effects
  • Cicatrix / etiology*
  • Female
  • Humans
  • Pregnancy
  • Version, Fetal*
  • Young Adult