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External cephalic version: experience of a maternal-fetal unit

Author(s): Cristina Fadigas

Journal: Acta Obstetrica e Ginecologia Portuguesa
ISSN 1646-5830

Overview and Aims. External cephalic version (ECV) consists in the rotation of the fetus from breech to vertex presentation, resulting in decreased caesarean sections and associated complications. The aim of this study was to evaluate the success rate of the technique, as well as associated maternal and fetal complications.Study Design. Retrospective observational studyPopulation. All ECVs performed at our unit from 1997 to 2009.Methods. ECV was performed in singleton pregnancies in breech presentation or transverse lie, after exclusion of placenta previa, previous uterine scar, presence of a nuchal cord, oligohydramnios, fetal malformation or fetal growth restriction. The manoeuvres were performed by a single operator, under tocolysis and after a reactive non-stress test was recorded. Results. A total of 164 ECVs were performed on 159 pregnant women (five had a second attempt after a first unsuccessful ECV). In two pregnancies the fetus was sucessively rotated from a transverse lie. In the remaining 157 women the fetuses were in breech presentation, and a success rate of 44.4% was obtained. Temporary fetal bradychardia was documented in five cases (3%), and no other serious maternal or fetal complications were observed.Conclusions. ECV appears to be a safe procedure when applied to selected populations, and has a reasonable sucess rate.

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