External cephalic version for breech presentation at term (Cochrane Review)

A substantive amendment to this systematic review was last made on 06 July 1995. Cochrane reviews are regularly checked and updated if necessary.

Background: Management of breech presentation is controversial, both in regard to manipulation of the position of the fetus and the method of delivery. External cephalic version may reduce the number of breech presentations and caesarean sections, but there also have been reports of increased perinatal mortality with the procedure.

Objectives: The objective of this review was to assess the effects of external cephalic version at term on measures of pregnancy outcome.

Search strategy: The Cochrane Pregnancy and Childbirth trials register was searched. Date of last search: October 2001.

Selection criteria: Randomised trials of external cephalic version at term (with or without tocolysis) compared with no attempt at external cephalic version in women with breech presentation.

Data collection and analysis: Eligibility and trial quality were assessed by GJH and checked by RK.

Main results: Six studies were included. External cephalic version at term was associated with a significant reduction in non-cephalic births (relative risk 0.42, 95% confidence interval 0.35 to 0.50) and caesarean section (relative risk 0.52, 95% confidence interval 0.39 to 0.71). There was no significant effect on perinatal mortality (relative risk 0.44, 95% confidence interval 0.07 to 2.92).

Reviewers' conclusions: Attempting cephalic version at term appears to reduce the chance of non-cephalic births and caesarean section. There is not enough evidence to assess any risks of external cephalic version at term.

Citation: Hofmeyr GJ, Kulier R. External cephalic version for breech presentation at term (Cochrane Review). In: The Cochrane Library, Issue 3, 2003. Oxford: Update Software.

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This is an abstract of a regularly updated, systematic review prepared and maintained by the Cochrane Collaboration. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).

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