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

A substantive amendment to this systematic review was last made on 29 June 1994. 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 for breech presentation before term on measures of pregnancy outcome.

Search strategy: The Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register were searched. Date of last search: October 2001.

Selection criteria: Randomised and quasi-randomised trials of external cephalic version before term (37 weeks gestation) compared with a control group in women with breech presentation before term.

Data collection and analysis: Eligibility and trial quality were assessed by the reviewer.

Main results: Three studies involving 889 women were included. There was no significant effect of external cephalic version before term on the following: non-cephalic presentation (relative risk 1.02, 95% confidence interval 0.89 to 1.17); caesarean section (relative risk 1.10, 95% confidence interval 0.78 to 1.54); low Apgar scores (relative risk 0.81, 95% confidence interval 0.44 to 1.49); perinatal mortality (relative risk 1.19, 95% confidence interval 0.46 to 3.05).

Reviewers' conclusions: External cephalic version before term does not appear to improve pregnancy outcomes.

Citation: Hofmeyr GJ. External cephalic version for breech presentation before 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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