External cephalic version at a military teaching hospital: predictors of success. 1995

B C Calhoun, and D Edgeworth, and W Brehm
Department of Obstetrics and Gynecology, USAF Medical Center, Keesler, Mississippi 39534, USA.

The purpose of this prospective study was to analyze our experience with external cephalic version under tocolysis. This included an expected (1) high success rate of version, (2) infrequent occurrence of reversion, (3) reduction in the incidence of intrapartum breech presentation, avoiding the need for Caesarean delivery, and (4) predictors of success in our series. The study spanned the period from 1985 to 1993, enrolling 113 subjects who presented to our OB/GYN Department with any type of breech presentation at 37 weeks' gestation or greater and met the following criteria: (1) absence of labour or ruptured membranes, (2) singleton pregnancy, (3) absence of medical or obstetrical complications and amniotic fluid index of greater than 8 cm. After a reassuring fetal assessment, IV terbutaline was given prior to an attempt at version. The results revealed a 46% (53 or 113) version success rate with a 4% (2 of 53) reversion within a week after procedure. There was a 2% (2 of 113) complication rate, with 1 being a minor incident of fetal bradycardia that responded easily to intrauterine resuscitation. One major complication occurred with placental abruption during the attempt, which required immediate Caesarean delivery. Predictors of success in our series included: multiparity, fundal/posterior placenta, and fetal head and spine on the corresponding side of the maternal sagittal plane. External cephalic version in a controlled setting can be a safe procedure for residents in training that lowers Caesarean delivery rate for breech presentation.

UI MeSH Term Description Entries
D008922 Mississippi State bounded on the north by Tennessee, on the east by Alabama, on the south by Louisiana and Gulf of Mexico, and on the west by Arkansas and Louisiana.
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D002585 Cesarean Section Extraction of the FETUS by means of abdominal HYSTEROTOMY. Abdominal Delivery,Delivery, Abdominal,C-Section (OB),Caesarean Section,Postcesarean Section,Abdominal Deliveries,C Section (OB),C-Sections (OB),Caesarean Sections,Cesarean Sections,Deliveries, Abdominal
D004630 Emergencies Situations or conditions requiring immediate intervention to avoid serious adverse results. Emergency
D005260 Female Females
D006772 Hospitals, Military Hospitals which provide care for the military personnel and usually for their dependents. Hospitals, Air Force,Hospitals, Army,Hospitals, Navy,Air Force Hospitals,Army Hospitals,Military Hospitals,Navy Hospitals,Air Force Hospital,Army Hospital,Hospital, Air Force,Hospital, Army,Hospital, Military,Hospital, Navy,Military Hospital,Navy Hospital
D006784 Hospitals, Teaching Hospitals engaged in educational and research programs, as well as providing medical care to the patients. Hospital, Teaching,Teaching Hospital,Teaching Hospitals
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014710 Version, Fetal The artificial alteration of the fetal position to facilitate birth. External Cephalic Version,Fetal Version,Version, External Cephalic,Cephalic Version, External,Cephalic Versions, External,External Cephalic Versions,Fetal Versions,Versions, External Cephalic,Versions, Fetal

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