PREGNANCY OUTCOME IN EXTERNAL CEPHALIC VERSION FORBREECH PRESENTATION

Objective: To determine the outcome of external cephalic version in breech presentation and to analyze the perinatal and the maternal outcome.

Study Design: A prospective study was performed of 30 patients with breech presentation at 34 weeks or more period of gestation were enrolled. External Cephalic Version (ECV) was carried out in selected cases after applying inclusion and exclusion criteria at or after 37 weeks of gestation. These patients were followed up till the time of delivery for type of delivery, maternal and neonatal outcome. Data so accumulated was analyzed at the end of the study.

Results:Out of 30 attempted ECV 18 were successful out of which one reverted back to breech after initial successful external cephalic version. Total success rate of external cephalic version in the study was 60 percent (95% CI 43.3, 76.7) and failure rate was 40 percent (95% CI 23.3, 56.7). Of the total attempted ECV; 20 (66.7 %) were in nulliparous women, 08 (26.7 %) were in primiparous women and 02 (6.6 %) were in multiparous women. Total success rate in nulliparous women was 55 percent (11 out of 20), total success rate in primiparous women was 62.5 percent (5 out of 8) and all two cases of external cephalic version were successful in multiparous group. External cephalic version failure rates were 45 percent (9 out of 20) in nulliparous, and 37.5 percent (3 out of 8) in primiparous women respectively. There were no cases of failed external cephalic version in multiparous group.

Conclusion: External Cephalic Version is a cost effective, bed side and relatively safe procedure in experienced hands for doing so. Most of the cases of breech presentation are delivered by cesarean section in current obstetric practice. External cephalic version can be tried in selected cases before taking them up for cesarean section.