Journal of Rawalpindi Medical College (Jun 2021)
To determine the rate of success of external cephalic version in low risk breech presentations and possible factors affecting its success in POF hospital, Wah Cantt.
Abstract
Abstract Background The caesarean section rate is on the rise for various reasons. One of the reason is breech presentation . External cephalic version is a procedure to manipulate the baby from breech to cephalic presentation externally through the maternal abdomen under USG guidance . Success in ECV decreases the breech presentation and hence caesarean section rate . Methods This retrospective study was conducted by Wah Medical College in POF hospital from10 Oct 2015- 10 Oct 2019 after approval from the ethical committee . It included 56 low risk singleton breech presentations from 36 wks- 40 wks after taking their informed consent While those with 40 wks gestation, refusal to ECV , with absolute contraindication to ECV& with medical and obstetric complications (ie scarred uterus, liquor than 17 cm, fetal growth restriction, preclampsia, gestational diabetes & abnormal cardiotocography) were excluded from the study. ECV was performed by single obstetrician in labour room with facilities of cardiotocograph and emergency caesarean section. Cardiotocography of the fetus for 30-40 min was done just before & after the procedure of ECV. ECV was declared successful on cofirming head of the fetus occupying the lower uterine segment on ultrasound. .Number of successful ECVs & specific factors of the women & the baby (age . parity, amniotic fluid index ,type of breech, engagement of breech, position of back of baby) were chosen to observe their effect on success of ECV. Results External cephalic version was successful in 27 (48.2%) & unsuccessful in 29 (51.8%)of women .Multiparity , unengaged breech & type of breech (complete flexed) ( with p values .001, .000 & .001 respectively) had statistically significant positive association with successful external cephalic version. Conclusion ECV should be offered to all women with low risk breech presentations. Knowledge of factors predictive of ECV success can be utilized in selecting cases for ECV &counselling the women regarding the success and failure of ECV.
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