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Late preterm versus term external cephalic version: an audit of a single obstetrician experience

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Recent literature evaluating the optimal timing for external cephalic version (ECV) in non-cephalic presentation is limited and hampered by methodological issues. We aimed to compare late preterm ECV [term (36–37 weeks of gestation] to term ECV ( > 37 weeks).

Methods

We conducted a retrospective cohort study of prospectively collected data of ECV procedures performed by a single operator during a 6 year period. Maternal, ECV procedure, delivery and fetal characteristics were compared between preterm ECV and term ECV.

Results

Overall, 547 (91.6%) of ECVs were term ECV while 50 (8.4%) procedures were preterm ECV. Success rate of ECV was 72.0% in the preterm ECV group vs. 71.5% in the term ECV group, p = 0.93. Proportion of preterm delivery was higher among the preterm ECV group (8% vs. 0%, p < 0.001), so does the proportion of early term deliveries (36.0% vs. 22.8%, p = 0.03). The rate of low birth weight was higher among the preterm ECV group (10.0% vs. 3.11%, p = 0.01). Rates of Apgar score at 5 min ≤ 8 were higher in the preterm ECV (4.0% vs. 0.5%, p = 0.007). Vaginal delivery and intrapartum cesarean delivery rates did not differ between study groups (72.0% vs. 73.2%, p = 0.83 and 10% vs. 8.4%, p = 0.69).

Conclusion

Initiating ECV before term is associated with increased rate of preterm delivery, early term delivery and low birth weight. No effect was found in mode of delivery, intrapartum cesarean delivery, reversion and spontaneous version. We advocate against preterm ECV until future prospective trials will better delineate the effect of preterm ECV on maternal and neonatal outcomes.

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Abbreviations

ECV:

External cephalic version

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Funding

No external funding was used in this conduct of this study.

Author information

Author notes

  1. Gabriel Levin and Amihai Rottenstreich contributed equally.

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, POB 12000, 91120, Jerusalem, Israel

    Gabriel Levin & Amihai Rottenstreich

  2. Department of Ophthalmology, Shaare Zedek Medical Center, Jerusalem, Israel

    Yishay Weill

  3. Department of Obstetrics and Gynecology, Meuhedet HMO, Jerusalem, Israel

    Raphael N. Pollack

Authors
  1. Gabriel Levin
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  2. Amihai Rottenstreich
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  3. Yishay Weill
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  4. Raphael N. Pollack
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Contributions

All authors contributed to the manuscript. GL and AR reviewed the literature and wrote the paper. YW and RNP treated the patients.

Corresponding author

Correspondence to Gabriel Levin.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

For this type of study formal consent is not required and was waived by the institutional review board approval. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Levin, G., Rottenstreich, A., Weill, Y. et al. Late preterm versus term external cephalic version: an audit of a single obstetrician experience. Arch Gynecol Obstet 300, 875–880 (2019). https://doi.org/10.1007/s00404-019-05244-3

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  • DOI: https://doi.org/10.1007/s00404-019-05244-3

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