Outcome of external cephalic version: our experience

Ultrasound factors to predict the outcome of external cephalic version: a meta-analysis

OBJECTIVE

To systematically review the medical literature reporting on ultrasound factors that can be predictive for the outcome of an attempt at external cephalic version (ECV).

METHODS

MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials were searched. Studies reporting on potential ultrasound prognosticators and ECV success rates that allowed construction of a 2x2 table were selected.

RESULTS

We selected 37 primary articles reporting on 7709 women. Posterior placental location (odds ratio (OR), 1.9; 95% CI, 1.5-2.4), complete breech position (OR, 2.3; 95% CI, 1.9-2.8) and an amniotic fluid index>10 (OR, 1.8; 95% CI, 1.5-2.1) were predictors of successful ECV.

CONCLUSION

Success of an ECV attempt is associated with ultrasound parameters such as fetal position, amniotic fluid and placental location. This knowledge can be used to develop a prognostic model to predict successful ECV.

Clinical factors to predict the outcome of external cephalic version: a metaanalysis

OBJECTIVE

The objective of the study was to systematically review the medical literature reporting on potential clinical prognosticators for the outcome of external cephalic version (ECV).

STUDY DESIGN

Medline, EMBASE, and Cochrane Central Register of Controlled Trials were searched. Studies reporting on potential clinical prognosticators and ECV success rates that allowed construction of a 2 x 2 table were selected.

RESULTS

We detected 53 primary articles reporting on 10,149 women. Multiparity (P >/= 1.00; odds ratio [OR], 2.5; 95% confidence interval [CI], 2.3-2.8), nonengagement of the breech (OR, 9.4; 95% CI, 6.3-14), a relaxed uterus (OR, 18; 95% CI, 12-29), a palpable fetal head (OR, 6.3; 95% CI, 4.3-9.2), and maternal weight less than 65 kg (OR, 1.8; 95% CI, 1.2-2.6) were predictors for successful external cephalic version.

CONCLUSION

Success of an ECV attempt is associated with clinical factors. This should be taken into account in the counseling of women prior to an ECV attempt.