[Cord accident after external cephalic version: Reality or mostly myth?]

Gynecol Obstet Fertil Senol. 2017 Jan;45(1):9-14. doi: 10.1016/j.gofs.2016.12.001. Epub 2017 Jan 17.
[Article in French]

Abstract

Objectives: To study the occurrence of cords accident (nuchal cords, prolapse, and braces) after external cephalic version according to its failure or success.

Methods: Retrospective study between 1998-2015 comparing in the cord accident diagnosed at delivery (by midwife or doctors according to mode of delivery): Patients with attempt ECV: Group 1 cephalic presentation after successful ECV with trial of labor, and Group 2 failed ECV followed by elective cesarean or trial of labor. Patients with no attempt ECV Group 3 spontaneous cephalic presentation matching for delivery date, maternal age, parity, body mass index, and delivery history with group 1, Group 4 Breech presentation without attempt ECV with trial of labor.

Results: A total of 776 women with breech presentation were included (198 in group 1, 446 in group 2, 396 in group 3 and 118 in group 4). The prevalence of cord accident did not differ according to ECV attempt (17.08 % versus 18.9 %), to cephalic presentation (group 1: 24.7 % versus group 3: 25 %) and to breech presentation (group 2: 16.9 % versus group 4: 17.2 %). The trial of labor after failed ECV did not increase the risk of cord accident when compared with elective cesarean (17.4 % versus 16 %). A prolapse cord was only observed after trial of labor, i.e. in groups 1, 2 and 4 without difference (respectively 1, 0.8 and 1.7 %). In each group, the rate of cesarean was not different according to the presence of nuchal cord.

Conclusion: Success or failed External cephalic version is not associated with an increased risk of cord accident.

Keywords: Cesarean; Circulaire; Cord; Cordon; Césarienne; External cephalic version; VME.

MeSH terms

  • Breech Presentation / therapy*
  • Cesarean Section
  • Female
  • Humans
  • Nuchal Cord / epidemiology
  • Obstetric Labor Complications / epidemiology
  • Pregnancy
  • Pregnancy Complications / epidemiology*
  • Prolapse
  • Retrospective Studies
  • Risk Factors
  • Trial of Labor
  • Umbilical Cord*
  • Version, Fetal / adverse effects*