Abstract
Objective: To assess the effectiveness of ECV in singleton breech presentation at term and to determine its
effect on maternal, delivery and perinatal outcomes in women to whom the procedure was offered.
Study Design: A quasi experimental study
Place and Duration of Study: The study was carried out in the Department of Obstetrics and Gynaecology,
Railway hospital, Rawalpindi, from August 2006 to December 2008.
Material and Methods: Eligible women, presenting with uncomplicated breech, between 37-41 weeks
gestation, underwent ECV on day care basis. Fifteen minutes before the procedure, injection salbutamol 0.5 mg
was administered. Cases with contraindication to ECV or salbutamol injection were excluded from the study.
Success rate of ECV (in terms of conversion from breech to cephalic presentation at the completion of procedure
confirmed through ultrasound) along with maternal, delivery and perinatal outcomes were assessed. Maternal
and fetal demographic characteristics were also recorded as secondary outcome measures. For statistical
analysis, SPSS version 10 was used and Chi-square test applied with a p<0.05 taken as significant.
Results: Of the 42 ECV procedures, 25 (59.5%) were successful. None of the patient suffered from serious
maternal complications. Seven (16.7%) parturients complained of severe palpitations and 4 (9.5%) of marked
discomfort during the procedure. Reversible fetal bradycardia was seen in 1 (2.4%) patient. Reversion to a non
cephalic presentation occurred in two cases. Vaginal delivery was carried out in 21 patients out of the 25 who
successfully underwent external cephalic version while all the patients with failed ECV underwent caesarean
delivery. The 5 minute Apgar score was more than 8 in all except one baby.
Conclusion: Adverse maternal and fetal outcomes of breech presentation at term are rare and there was no
increased risk of complications after external cephalic version. Findings provide important data to quantify the
frequency of adverse outcomes that will help facilitate informed decision-making and ensure optimal
management of breech presentation.
Shamsunnisa Sadia, Shamsa Rizwan, Saadia Sultana, Fareesa Waqar, Raazia Rauf, Shaheena Owais. (2011) External Cephalic Version (ECV) for Breech Presentation at Term -Experience at Railway Hospital, Journal of Islamic International Medical College, Volume-6, Issue-1.
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