IMPACT OF EXTERNAL CEPHALIC VERSION (ECV) ON MODE OF DELIVERY OFTHE TERM SINGLETON BREECH

Objective: To asses the impact of external cephalic version (ECV) on the mode of delivery of the uncomplicated term, singleton breech at teaching hospital. Material and Methods: This observational study was conducted in Obstetrics and Gynecology department, Hayatabad Medical Complex, Peshawar from 1st December 2003 to 31st January 2005 on all singleton term breech presentations from 37 to 41 weeks of gestation. Results: Out of 265 women presenting with breech presentation at 37 completed weeks or more at our unit during the study period, 188 patients met the selection criteria. Of these only 40 patients (21.3%) had ECV. Twenty seven of these were successful (67%). A total of 161 patients continued their pregnancies as breech. Of these the mode of the delivery was: Vaginal Breech Delivery in 97 cases (60.24%) and CSection in 64 (39.76%). Reasons for failure to offer ECV included; 129 (80.12%) cases were unbooked and admitted in emergency when ECV services were not available. 145 (90%) were admitted in labour, and majority of these were in active and advanced labour. Conclusion: ECV was not found to decrease significantly the number of non-cephalic presentation at term. The reasons were that in spite of good success rates it was not feasible to perform enough ECV to have an impact on mode of delivery of singleton term breeches.