Frequency of External Cephalic Version in Women with Breech Presentation at Term
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Abstract
Background: External cephalic version (ECV) is a pivotal obstetric procedure aimed at reducing caesarean section rates by correcting fetal breech presentation to cephalic presentation through maternal abdominal manipulation. Despite its established efficacy, variability in success rates across different populations and healthcare settings highlights the need for continued evaluation of its clinical application and outcomes.
Objective: To assess the success rate of ECV in term pregnancies with breech presentation and identify factors influencing its outcomes in a tertiary care setting.
Methods: This cross-sectional study was conducted at the Gynecology & Obstetrics Unit of Lady Reading Hospital, Peshawar, between November 21, 2019, and May 21, 2020. A sample size of 100 women with singleton pregnancies, aged 20-35 years, presenting with breech at term (37-42 weeks), was included using non-probability consecutive sampling. Exclusion criteria encompassed contraindications to vaginal delivery or ECV. Data on demographic characteristics, obstetric history, and ECV outcomes were collected. The procedure was performed by experienced obstetricians under ultrasound guidance. Statistical analysis was conducted using SPSS version 25.0, with chi-square tests applied to assess associations between variables and ECV success.
Results: The mean age of participants was 30 years (SD ± 5.887), with a mean gestational age of 38 weeks (SD ± 3.94). The success rate of ECV was 57%. Multigravida women constituted 73% of the sample. No significant associations were found between ECV success and age groups (P=0.8792), gestational period (P=0.9699), gravidity (P=0.7813), obesity (P=0.7519), or educational level (P=0.9668).
Conclusion: The study confirms a 57% success rate for ECV in correcting breech presentations at term, reinforcing the procedure's role in potentially reducing the need for caesarean sections. These findings support the incorporation of ECV into obstetric practice as a standard of care for eligible women with breech presentations, highlighting the necessity for skilled providers and patient education to optimize outcomes.
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