Article Text

Audit of external cephalic version
  1. S Kumari,
  2. K Upadhyay,
  3. L Blake
  1. Wrexham Maelor Hospital, Wrexham, UK

Abstract

Background Breech presentation complicates 3–4% of all term deliveries. The term breech trial, a multi-centre trial across 121 centres in 26 countries during 1997–2000, randomising 2088 women to ‘planned Caesarean section’ or ‘planned vaginal’ deliveries found that Caesarean section was associated with reduced risk of perinatal morbidity and mortality. Since the publication of this trial there has been increase in incidence of Caesarean section for breech presentation. external cephalic version (ECV) reduces the chance of breech presentation at delivery, therefore the Caesarean section rate.

Aim To determine the success rate and complications of ECV, mode of delivery following successful ECV and to compare it with a standard.

Standard Royal College of Obstetricians and Gynaecologists guideline No-20A.

Methodology It was a retrospective study of all ECVs performed during July 2006 to June 2009. 72 patients were identified from ECV folder containing duly filled proformas for every ECV performed on the labour ward. Further details were collected from labour ward birth register and individual case records. Data were recorded on Microsoft spread sheet and analysed.

Outcomes (1) The success rate of ECV was 44% (Primigravidae 33%, Multigravidae 54%) which was comparable to the standard. (2) Most women delivered vaginally following successful ECV. (3) There were NO complications. (4) The guideline was followed appropriately.

Recommendations (1) To do audit on percentage of women with breech presentation offered ECV. (2) To design procedure specific consent form. (3) To do survey of maternal perception of ECV.

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