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Successful vaginal delivery after external cephalic version (ECV): does time interval from ECV to delivery make a difference? A multicenter study

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

The risk of cesarean delivery after a successful external cephalic version for breech presentation is higher as compared with fetuses in cephalic presentation. However, the role of the time interval between version attempt to delivery on the risk for cesarean delivery is unclear. We aimed to study the effect of the time interval from a successful external cephalic version to delivery on the risk for cesarean delivery and assess factors associated with cesarean delivery after a successful version.

Methods

We conducted a multicenter, retrospective cohort study, including all successful external cephalic version at two medical centers between 2011 and 2019. We compared patient baseline characteristics, obstetric characteristics, maternal and neonatal outcomes in women that delivered by vaginal delivery with those who delivered by cesarean delivery.

Results

Overall, 769 deliveries were included. Of these, 98 women (12.7%) had cesarean delivery and 671 (87.3%) had vaginal delivery. Women who had cesarean delivery had a higher rate of obesity (44.9% vs 21.9%, p < 0.001; OR 2.88, CI 1.65–5.03) and nulliparity (45.9% vs 24.5%, p < 0.001; OR = 2.58, CI 1.67–3.98). The risk for intrapartum cesarean delivery did not differ according to time interval from external cephalic version to delivery.

Conclusions

The time interval between successful external cephalic version and delivery was not associated with mode of delivery. This finding is in contrast to previous reports. The risk for cesarean delivery after successful version is higher in nulliparous, obese women, and women whose weight gain in pregnancy was higher.

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Funding

No specific funding or support was obtained for the purpose of this study.

Author information

Author notes

  1. Tal Cahan and Gabriel Levin have equal contribution.

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, 52621, Ramat Gan, Israel

    Tal Cahan, Orit Moran & Raanan Meyer

  2. Tel Aviv University, Tel Aviv, Israel

    Tal Cahan, Orit Moran & Raanan Meyer

  3. Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel

    Gabriel Levin

  4. Shaare Zedek Medical Center, Jerusalem, Israel

    Yishay Weill

  5. Department of Obstetrics and Gynecology, Meuhedet HMO, Jerusalem, Israel

    Raphael Pollack

Authors
  1. Tal Cahan
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  2. Gabriel Levin
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  3. Orit Moran
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  4. Yishay Weill
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  5. Raphael Pollack
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  6. Raanan Meyer
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by TC, GL, YW, RP and RM. The first draft of the manuscript was written by TC and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. TC: data collection and management, project development, manuscript writing/editing. GL: data collection and management, project development, data analysis, manuscript writing/editing. OM: data collection and management, project development. YW: data collection and management. RP: data collection and management. RM: data collection and management, project development, manuscript writing/editing.

Corresponding author

Correspondence to Tal Cahan.

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Conflict of interest

The authors of this study have no conflict of interest to attest for.

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Bikur Cholim Medical Center and Sheba Medical Center (IORG0001519 and 5319–18-SMC).

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Cahan, T., Levin, G., Moran, O. et al. Successful vaginal delivery after external cephalic version (ECV): does time interval from ECV to delivery make a difference? A multicenter study. Arch Gynecol Obstet 302, 1361–1367 (2020). https://doi.org/10.1007/s00404-020-05733-w

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  • DOI: https://doi.org/10.1007/s00404-020-05733-w

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