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Influence of the external cephalic version attempt on the Cesarean section rate: experience of a type 3 maternity hospital in France

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

Abstract

Purpose

To define the effects of attempted external cephalic version (ECV) in a low-risk population for breech delivery in a maternity hospital where breech vaginal delivery is widely practiced.

Materials and methods

Retrospective exposed—unexposed study including 204 patients presented with a live singleton fetus breech presentation on third-trimester ultrasound and who delivered at Reims University Hospital between January 1st, 2013 and July 1st, 2018.

Results

121 patients received ECV. Cesarean section rate was lower (OR with no adjustment 0.42 [0.24–0.76] p = 0.004) but without significant difference in the exposed patients after adjustment. This difference was significant between exposed and unexposed patients in the subgroup of 51 primiparous (OR = 0.14 [0.04–0.52] p = 0.002) and 51 multiparous (OR = 0.26 [0.08–0.89] p = 0.028) but not in the subgroup of 102 nulliparous. There was no difference in fetal impact other than neonatal management in the delivery room, which is less needed in exposed primiparous women. Attempted ECV significantly decreased the breech rate (72.5 vs 100%, p < 0.001). There were 7 (5.79%) complications. Three factors favored success: high uterine height (p = 0.011), a non-elevated BMI (p = 0.006) and an earlier term at ECV (p = 0.003).

Conclusion

The attempt of ECV in the Reims University Hospital does not significantly reduce the Cesarean section rate and has no effect on neonatal status.

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Funding

The authors declared that this study received no financial support.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Reims University Hospital, Reims, France

    Benjamin Birene, U. Ishaque, S. Bonneau, R. Gabriel & O. Graesslin

  2. Department of Research and Public Health, Reims University Hospital, Reims, France

    J. Chrusciel

Authors
  1. Benjamin Birene
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  2. U. Ishaque
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  3. J. Chrusciel
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  4. S. Bonneau
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  5. R. Gabriel
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  6. O. Graesslin
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Contributions

BB: Protocol development, Data collection, Manuscript writing. UI: Manuscript editing, methodology supporting, Supervision. JC: Data analysis. SB: Manuscript editing. RG: Manuscript editing. OG: Manuscript editing. All authors contributed to the study conception and design. Material preparation and data collection were performed by BB and analysis were performed by JC. The first draft of the manuscript was written by BB and all the authors commented on previous versions of the manuscript. All the authors read and approved the final manuscript.

Corresponding author

Correspondence to Benjamin Birene.

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The authors declare that they have no conflict of interest.

Ethical approval

This research study was conducted retrospectively from data obtained for clinical purposes. All procedures performed in studies involving human participants were in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Birene, B., Ishaque, U., Chrusciel, J. et al. Influence of the external cephalic version attempt on the Cesarean section rate: experience of a type 3 maternity hospital in France. Arch Gynecol Obstet 303, 443–454 (2021). https://doi.org/10.1007/s00404-020-05765-2

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  • DOI: https://doi.org/10.1007/s00404-020-05765-2

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