2018Evidence-Based PracticeRequires access

Does external cephalic version for breech presentation performed prior to an estimated gestational age of 37 weeks offer any benefits or pose any risks compared with external cephalic version performed at term?

Amy Matheny, J.A. Mata

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Abstract

EVIDENCE-BASED ANSWER Compared with term external cephalic version, preterm (<37 weeks' gestation) external cephalic version decreases the rate of noncephalic presentation at birth by 19% and the rate of vaginal breech birth by 56%, but increases the risk of late preterm birth by 50% (SOR: A, systematic review of RCTs). The 2016 American College of Obstetrician and Gynecologists guidelines for the management of external cephalic version recommend offering the procedure near term. In comparison, the 2010 guidelines from the Royal College of Obstetricians and Gynaecologists recommend external cephalic version at 36 weeks for nulligravidas and 37 weeks for multigravidas (SOR: C, systematic guidelines).

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EVIDENCE-BASED ANSWER Compared with term external cephalic version, preterm (<37 weeks' gestation) external cephalic version decreases the rate of noncephalic presentation at birth by 19% and the rate of vaginal breech birth by 56%, but increases the risk of late preterm birth by 50% (SOR: A, systematic review of RCTs). The 2016 American College of Obstetrician and Gynecologists guidelines for the management of external cephalic version recommend offering the procedure near term. In comparison, the 2010 guidelines from the Royal College of Obstetricians and Gynaecologists recommend external cephalic version at 36 weeks for nulligravidas and 37 weeks for multigravidas (SOR: C, systematic guidelines).

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Available abstract

EVIDENCE-BASED ANSWER Compared with term external cephalic version, preterm (<37 weeks' gestation) external cephalic version decreases the rate of noncephalic presentation at birth by 19% and the rate of vaginal breech birth by 56%, but increases the risk of late preterm birth by 50% (SOR: A, systematic review of RCTs). The 2016 American College of Obstetrician and Gynecologists guidelines for the management of external cephalic version recommend offering the procedure near term. In comparison, the 2010 guidelines from the Royal College of Obstetricians and Gynaecologists recommend external cephalic version at 36 weeks for nulligravidas and 37 weeks for multigravidas (SOR: C, systematic guidelines).

Key concepts: External cephalic version, Breech presentation, Cephalic presentation, Medicine, Gestational age, Obstetrics, Gestation, Presentation (obstetrics)

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Does external cephalic version for breech presentation performed prior to an estimated gestational age of 37 weeks offer any benefits or pose any risks compared with external cephalic version performed at term? — Research Paper | ScholarLens