Clinical factors to predict the outcome of external cephalic version: a metaanalysis

Am J Obstet Gynecol. 2008 Dec;199(6):630.e1-7; discussion e1-5. doi: 10.1016/j.ajog.2008.03.008. Epub 2008 May 23.

Abstract

Objective: The objective of the study was to systematically review the medical literature reporting on potential clinical prognosticators for the outcome of external cephalic version (ECV).

Study design: Medline, EMBASE, and Cochrane Central Register of Controlled Trials were searched. Studies reporting on potential clinical prognosticators and ECV success rates that allowed construction of a 2 x 2 table were selected.

Results: We detected 53 primary articles reporting on 10,149 women. Multiparity (P >/= 1.00; odds ratio [OR], 2.5; 95% confidence interval [CI], 2.3-2.8), nonengagement of the breech (OR, 9.4; 95% CI, 6.3-14), a relaxed uterus (OR, 18; 95% CI, 12-29), a palpable fetal head (OR, 6.3; 95% CI, 4.3-9.2), and maternal weight less than 65 kg (OR, 1.8; 95% CI, 1.2-2.6) were predictors for successful external cephalic version.

Conclusion: Success of an ECV attempt is associated with clinical factors. This should be taken into account in the counseling of women prior to an ECV attempt.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Adult
  • Birth Injuries / epidemiology*
  • Birth Injuries / prevention & control
  • Breech Presentation / diagnostic imaging*
  • Cesarean Section / methods
  • Cesarean Section / statistics & numerical data
  • Female
  • Follow-Up Studies
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Male
  • Parity
  • Predictive Value of Tests
  • Pregnancy
  • Pregnancy Outcome
  • Randomized Controlled Trials as Topic
  • Risk Assessment
  • Ultrasonography
  • Version, Fetal / methods*
  • Young Adult