Ronald J Collaris1, S Guid Oei. 1. Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, the Netherlands.
Abstract
BACKGROUND: The Term Breech Trial has considerably increased the number of cesareans. External cephalic version (ECV) might be an effective method of lowering the rate of cesareans; its efficacy has been well established. However, although in the absence of anesthesia the risks are thought to be low, most studies have used populations too small to allow definite conclusions on version-related risks. METHODS: In an attempt to make an inventory of these risks, we have systematically analyzed 44 studies, covering a total of 7377 patients from 1990 to 2002. The studies used were derived from a Medline and Embase search. RESULTS: The most frequently reported complications were transient abnormal cardiotocography (CTG) patterns (5.7%). Persisting pathological CTG readings (0.37%) and vaginal bleeding occur rarely (0.47%). The incidence of placental abruption was even lower, at 0.12%. Fetomaternal transfusion was absent in five out of seven studies, with a mean incidence of 3.7%. Emergency cesareans were performed in 0.43% of all versions. Perinatal mortality was 0.16%. CONCLUSIONS: External cephalic version seems to be a safe procedure.
BACKGROUND: The Term Breech Trial has considerably increased the number of cesareans. External cephalic version (ECV) might be an effective method of lowering the rate of cesareans; its efficacy has been well established. However, although in the absence of anesthesia the risks are thought to be low, most studies have used populations too small to allow definite conclusions on version-related risks. METHODS: In an attempt to make an inventory of these risks, we have systematically analyzed 44 studies, covering a total of 7377 patients from 1990 to 2002. The studies used were derived from a Medline and Embase search. RESULTS: The most frequently reported complications were transient abnormal cardiotocography (CTG) patterns (5.7%). Persisting pathological CTG readings (0.37%) and vaginal bleeding occur rarely (0.47%). The incidence of placental abruption was even lower, at 0.12%. Fetomaternal transfusion was absent in five out of seven studies, with a mean incidence of 3.7%. Emergency cesareans were performed in 0.43% of all versions. Perinatal mortality was 0.16%. CONCLUSIONS:External cephalic version seems to be a safe procedure.
Authors: E K Hutton; M E Hannah; S J Ross; M-F Delisle; G D Carson; R Windrim; A Ohlsson; A R Willan; A Gafni; G Sylvestre; R Natale; Y Barrett; J K Pollard; M S Dunn; P Turtle Journal: BJOG Date: 2011-02-04 Impact factor: 6.531
Authors: Jonathan M Tan; Alex Macario; Brendan Carvalho; Maurice L Druzin; Yasser Y El-Sayed Journal: BMC Pregnancy Childbirth Date: 2010-01-21 Impact factor: 3.007