External cephalic version at term--using tocolysis.

Abstract

Fifty-five patients with non-vertex presentation at 37 to 40 weeks' gestation were evaluated to determine which factors were associated with a successful external cephalic version (ECV). Maternal parity, obesity, amniotic fluid volume, placental location, type of breech and position of fetal spine were analyzed. Only amniotic fluid volume and fetal weight were significantly associated with a successful version (p < 0.05), 40/55 (73%) were successfully converted, 36/55 (65%) were vertex at delivery, and 32/55 (58%) delivered vaginally. Version attempts were successful in six out of eight patients who had undergone a previous cesarean section. Two out of six of the successful version patients went on to have vaginal birth after cesarean section. We conclude that although ECV is a reasonable alternative in the management of pathological presentation near term it should be performed only when there is sufficient amniotic fluid volume.